BOWIE STATE UNIVERSITY NPI 1154888048

NPI Information

  • NPI: 1154888048
  • Provider Name: BOWIE STATE UNIVERSITY
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Organization
  • CLIA Number: 21D1045748
  • Address: 14000 JERICHO PARK ROAD
    HENRY WISE WELLNESS CENTER, CMRC, LOWER LEVEL
    BOWIE, MD
    ZIP 20715
  • Phone: (301) 860-4170

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NPI Details

BOWIE STATE UNIVERSITY is an adult health nurse practitioner in Bowie, MD. BOWIE STATE UNIVERSITY NPI is 1154888048. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

14000 JERICHO PARK ROAD
HENRY WISE WELLNESS CENTER, CMRC, LOWER LEVEL
BOWIE, MD
ZIP 20715
Phone: (301) 860-4170
Fax: (601) 860-4179

The provider's authorized official is Artie Lee Travis .
The authorized official title is Vice President Student Affairs and has the following contact phone number (301) 860-3390.

The CLIA number assigned to this NPI record is 21D1045748 - school/student health service with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/27/2019 and was last updated on 2/27/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1202K00000XPhlebologyNo
2207R00000XInternal MedicineNo
3363LX0001XNurse PractitionerObstetrics & GynecologyNo
4363LA2200XNurse PractitionerAdult HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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