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NPI Code Detail

MEDICARE: KRISTEN RENAE BOWEN NP

MEDICARE: KRISTEN RENAE BOWEN NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerBOWE-CVNKFNC

General Provider Information

NPI Number : 1184341869
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN RENAE BOWEN NP
Provider Business Mailing Address
First Line : 669 HENRY BERRY RD
Second Line :
City : ROWLAND
State : NC
Zip : 28383-9129
Country : US
Telephone Number : 910-506-9967
Fax Number :
Provider Business Practice Location Address
First Line : 2718 W ROSCOE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60618-5910
Country : US
Telephone Number : 773-961-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2022
Last Update Date : 10/24/2022

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