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General NPI Number Information
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NPI Number | 1558758086
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Entity Type | Individual
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Provider Name | JENNA BOWEN MD
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Gender | Female
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Dates
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Enumeration Date | 04/22/2015
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 6666 ODANA RD # 173
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City | MADISON
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State | WI
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Zip | 53719-1012
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Country | US
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Telephone | 925-608-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 6666 ODANA RD # 173
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City | MADISON
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State | WI
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Zip | 53719-1012
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Country | US
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Telephone | 925-608-8700
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A171651
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 5769
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | A171651
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 60829553
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 67523
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License Number State | WI
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Taxonomy #6
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 60829553
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License Number State | WA
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