Healthcare Provider Details

I. General information

NPI: 1649180548
Provider Name (Legal Business Name): KAYLI BOWMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 LOUISVILLE AVE
MONROE LA
71201-6030
US

IV. Provider business mailing address

1704 PLUM ST
MONROE LA
71202-3068
US

V. Phone/Fax

Practice location:
  • Phone: 318-322-3141
  • Fax:
Mailing address:
  • Phone: 318-855-9512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPST.026415
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: