Healthcare Provider Details

I. General information

NPI: 1114821477
Provider Name (Legal Business Name): RAUNYAI BOWREN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6511 JOHNSON DR
MISSION KS
66202-2616
US

IV. Provider business mailing address

7725 NW ROANRIDGE RD APT E
KANSAS CITY MO
64151-1654
US

V. Phone/Fax

Practice location:
  • Phone: 913-213-3224
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: