MR. ERIC R. BOWEN (NPI# 1811179344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811179344 |
| Entity Type | Individual |
| Full Name | MR. ERIC R. BOWEN |
| Credential | APNP |
| Practice Address |
2105 E. Enterprise Ave. Suite 111 Appleton WI 54913-7862 |
| Practice Telephone | 9207316611 |
| Practice Fax Number | 9207316732 |
| Mailing Telephone | 9207316611 |
| Mailing Fax Number | 9207316732 |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2016-03-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
6846-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | STATE LICENSE | 124080-030 | 01 |
| Street Address |
2105 E. ENTERPRISE AVE. SUITE 111 |
| City | APPLETON |
| State | WI |
| Zip Code | 54913-7862 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043254162 | Fvosa Surgical Partners, LLC | Clinic/Center | 2105 E. Enterprise Ave., Suite 101, Appleton, WI 54913 | 2006-06-16 |
| 1467702241 | Kara L Brochtrup | Nurse Practitioner | 2105 E. Enterprise Ave., Suite 111, Appleton, WI 54913-7862 | 2012-09-19 |
| 1629218417 | Nicole E. Juedes | Specialist/Technologist, Other | 2105 E. Enterprise Ave., Suite 111, Appleton, WI 54913-7862 | 2009-03-06 |
| 1053578682 | Todd A Derksen | Podiatrist | 2105 E. Enterprise Ave., Suite 111, Appleton, WI 54913-7862 | 2008-05-21 |
| 1720023724 | Great Lakes Orthotics & Prosthetics Inc. | Prosthetic/Orthotic Supplier | 2105 E. Enterprise Ave., Suite 114, Appleton, WI 54913 | 2006-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457994584 | Pamela J Andersen | Music Therapist | 245 N. Metro Drive, Appleton, WI 54913 | 2019-10-22 |
| 1396387510 | Nancy Sibley | Technician | N4423 County Road Ee, Appleton, WI 54913 | 2019-10-09 |
| 1659872240 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 3801 N. Richmond Street, Grand Chute, WI 54913 | 2018-02-28 |
| 1780116244 | Alison Pelger | Physician Assistant | 3916 North Intertech Court, Appleton, WI 54913 | 2017-04-03 |
| 1316311905 | Lucy Bouressa | Specialist/Technologist | 2105 E. Enterprise Ave, 113, Appleton, WI 54913 | 2015-11-19 |
| 1992189989 | Brittany Reinke | Physical Therapist | Walking and Wheeling, LLC, W4652 Glenn Street, Appleton, WI 54913 | 2015-07-20 |
| 1902280092 | Costco Wholesale Corporation | Pharmacy | 5401 W Integrity Way, Grand Chute, WI 54913 | 2015-07-17 |
| 1942646849 | Richard Anthony Mauthe | Pharmacist | 5401 W. Integrity Way, Neenah, WI 54913 | 2013-05-17 |
| 1750622163 | Tonya Janelle Wilderman | Pharmacist | 1400 N Mccarthy Rd, Apt 2, Grand Chute, WI 54913 | 2013-03-10 |
| 1295938777 | Jenna Marie Kadlec | Physical Therapist | 3916 N. Intertech Court, Appleton, WI 54913 | 2007-06-11 |
| Find all providers in zip 54913 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710306196 | Erin Lynn Dercks | Nurse Practitioner | 820 W Association Dr, Appleton, WI 54914-1495 | 2014-04-14 |
| 1790069599 | Michelle Manke | Nurse Practitioner | N9168 Cherry Meadow Dr, Appleton, WI 54915-4681 | 2011-09-28 |
| 1093018699 | Marcia Ann Smith | Nurse Practitioner | 4435 W Lawrence St, Appleton, WI 54914-4065 | 2010-12-21 |
| 1316989056 | Kay L Conradt | Nurse Practitioner | 2701 N Oneida St, Fox Valley Nephrology Partners Sc, Appleton, WI 54911 | 2006-06-10 |
| 1902458177 | Kelsey Gregory | Nurse Practitioner | 1506 S Oneida St, Appleton, WI 54915-1305 | 2019-07-09 |
| 1073022356 | Megan Elizabeth Galske | Nurse Practitioner | 820 E Grant St, Appleton, WI 54911-3483 | 2017-09-29 |
| 1982004420 | Amber Lee Carlsen | Nurse Practitioner | 2500 E Capitol Dr, Suite 700, Appleton, WI 54911-8735 | 2014-09-03 |
| 1417373952 | Jodi L Beggs | Nurse Practitioner | 1501 S Madison St, Surgery Department, Appleton, WI 54915-1846 | 2014-03-07 |
| 1619300027 | Trang Vo | Nurse Practitioner | 1818 N Meade St, Appleton, WI 54911-3454 | 2013-08-21 |
| 1619318714 | Deborah Ann Bartmann | Nurse Practitioner | 1501 S Madison St, Appleton, WI 54915-1846 | 2013-07-17 |
| Find all providers in APPLETON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.