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General NPI Number Information
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NPI Number | 1689383705
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Entity Type | Individual
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Provider Name | KEETON KELLY BOWER RN
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Gender | Female
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Dates
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Enumeration Date | 11/17/2022
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 10513 MARBACH RD STE 102
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City | SAN ANTONIO
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State | TX
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Zip | 78245-1995
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Country | US
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Telephone | 210-290-8081
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Fax |
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Provider Business Mailing Address
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Address Line | 142 MINNESOTA CIR
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City | JACKSONVILLE
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State | AR
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Zip | 72076-1127
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Country | US
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Telephone | 720-900-7115
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1177118
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 225947
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License Number State | AR
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