Healthcare Provider Details

I. General information

NPI: 1639267818
Provider Name (Legal Business Name): KATHRYN ANNE SIELBECK-BOWEN PHD CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 DESMOND ST SUITE 2
SAYRE PA
18840-2002
US

IV. Provider business mailing address

110 S ELMIRA ST
ATHENS PA
18810-1114
US

V. Phone/Fax

Practice location:
  • Phone: 570-882-9939
  • Fax:
Mailing address:
  • Phone: 570-882-9481
  • Fax: 570-882-1341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberJP002048D
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN2994921
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: