Healthcare Provider Details

I. General information

NPI: 1215880737
Provider Name (Legal Business Name): KHIA BOWERS LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2026
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7217 SE 15TH ST
MIDWEST CITY OK
73110-5235
US

IV. Provider business mailing address

10312 E RENO AVE
MIDWEST CITY OK
73130-3732
US

V. Phone/Fax

Practice location:
  • Phone: 405-671-8650
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number61120
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: