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General NPI Number Information
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NPI Number | 1235812231
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Entity Type | Individual
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Provider Name | JESSICA KRISTIE BOWEN DNP
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Gender | Female
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Dates
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Enumeration Date | 08/08/2023
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 134 MEDICAL PARK RD STE 200
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City | MOORESVILLE
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State | NC
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Zip | 28117-8527
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Country | US
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Telephone | 980-302-7800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 60447
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City | CHARLOTTE
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State | NC
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Zip | 28260-0447
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Country | US
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Telephone | 980-302-7800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9454570
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 5021049
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5021049
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN11028238
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License Number State | FL
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