Healthcare Provider Details

I. General information

NPI: 1093200776
Provider Name (Legal Business Name): JASMINE BOWIE MS.CMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2018
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 S ERIE HWY
HAMILTON OH
45011-4315
US

IV. Provider business mailing address

1584 ELIZABETH PL
CINCINNATI OH
45237-5623
US

V. Phone/Fax

Practice location:
  • Phone: 513-795-7557
  • Fax: 513-737-4603
Mailing address:
  • Phone: 513-439-0981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: