Healthcare Provider Details

I. General information

NPI: 1790638047
Provider Name (Legal Business Name): KRISTEN A BOWERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 DEADWOOD AVE
RAPID CITY SD
57702-0379
US

IV. Provider business mailing address

604 E LIBERTY ST
RAPID CITY SD
57701-7561
US

V. Phone/Fax

Practice location:
  • Phone: 970-443-3811
  • Fax:
Mailing address:
  • Phone: 970-443-3811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-320416
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number35468
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: