Healthcare Provider Details

I. General information

NPI: 1912440280
Provider Name (Legal Business Name): CHRISTY RENEE BOWLING APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2016
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 DIXIE HWY
FLORENCE KY
41042-2010
US

IV. Provider business mailing address

215 E 11TH ST
NEWPORT KY
41071-2203
US

V. Phone/Fax

Practice location:
  • Phone: 859-282-2024
  • Fax: 859-282-6747
Mailing address:
  • Phone: 859-655-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3010548
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: