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General NPI Number Information
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NPI Number | 1245118678
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Entity Type | Individual
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Provider Name | KELLY VIKTORIN BOWLEY RN
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Gender | Female
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 410 POPLAR AVE KJANSKYRN@GMAIL.COM
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City | KODIAK
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State | AK
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Zip | 99615-9961
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Country | US
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Telephone | 281-467-2573
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Fax |
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Provider Business Mailing Address
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Address Line | 410 POPLAR AVE KJANSKYRN@GMAIL.COM
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City | KODIAK
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State | AK
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Zip | 99615-9961
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Country | US
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Telephone | 281-467-2573
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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 | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number | 689023
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number | 243998
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License Number State | AK
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