Healthcare Provider Details

I. General information

NPI: 1710923743
Provider Name (Legal Business Name): KATHY BOWMAN N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 11/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 SOLAR DR SUITE 265
OXNARD CA
93036-2641
US

IV. Provider business mailing address

1901 SOLAR DR SUITE 265
OXNARD CA
93036-2641
US

V. Phone/Fax

Practice location:
  • Phone: 805-278-6840
  • Fax: 508-278-6838
Mailing address:
  • Phone: 805-278-6840
  • Fax: 805-278-6838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number474777
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: