Healthcare Provider Details

I. General information

NPI: 1851226732
Provider Name (Legal Business Name): KATE BOWER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 E REYNOLDS DR STE E3
RUSTON LA
71270-2873
US

IV. Provider business mailing address

206 E REYNOLDS DR STE E3
RUSTON LA
71270-2873
US

V. Phone/Fax

Practice location:
  • Phone: 318-232-2232
  • Fax: 318-301-3734
Mailing address:
  • Phone: 318-232-2232
  • Fax: 318-301-3734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number11318
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: