Bowman J Blake, APRN
Family Medicine in Orem, UT. Individual provider (NPI-1).
NPI number1992427892
StatusActive
Last updated in NPPESJun 23, 2025
Details
- NPI
- 1992427892
- Entity type
- Individual (NPI-1)
- Name
- Bowman J Blake
- Credential
- APRN
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 16, 2022
- Certification date
- Jun 23, 2025
- Last updated
- Jun 23, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 10709846-4405 | UT | Yes |
Practice location
35 S 400 WOrem, UT 84058-5324
Phone 801-800-2550 · Fax 801-705-4040
Mailing address
35 S 400 WOrem, UT 84058-5324
Phone 801-800-2550 · Fax 801-705-4040
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