Healthcare Provider Details

I. General information

NPI: 1992001937
Provider Name (Legal Business Name): NAKISHA RENEE BOWMAN REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2011
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 ASHLEY LN
PATASKALA OH
43062-7250
US

IV. Provider business mailing address

101 ASHLEY LN
PATASKALA OH
43062-7250
US

V. Phone/Fax

Practice location:
  • Phone: 937-609-0711
  • Fax:
Mailing address:
  • Phone: 937-609-0711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN.436871
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: