MEDICARE: JENNIFER NICOLE BOWLER DPN, PNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	2017019292	MO
2	163WP0200X	Pediatric Registered Nurse	2007011709	MO

General Provider Information

NPI Number	:	1013441013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER NICOLE BOWLER DPN, PNP

Provider Business Mailing Address
First Line	:	PO BOX 843966
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64184-3966
Country	:	US
Telephone Number	:	573-884-3300
Fax Number	:	573-884-0943

Provider Business Practice Location Address
First Line	:	701 VETERANS UNITED DR
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65201-4236
Country	:	US
Telephone Number	:	573-884-6052
Fax Number	:	573-884-8529

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2017
Last Update Date	:	03/23/2026

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