Healthcare Provider Details

I. General information

NPI: 1225949027
Provider Name (Legal Business Name): KATRINA MARIA BOWLES CPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16131 LANCASTER HWY STE 4
CHARLOTTE NC
28277-3884
US

IV. Provider business mailing address

10115 WHITEBURN CT
CHARLOTTE NC
28278-6638
US

V. Phone/Fax

Practice location:
  • Phone: 704-910-4484
  • Fax:
Mailing address:
  • Phone: 704-604-5439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberS113089
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: