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NPI Code Detail

MEDICARE: KIMBERLY L MOWRY LPN, QMHS

MEDICARE: KIMBERLY L MOWRY LPN, QMHS
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
1171M00000XCase Manager/Care Coordinator
2164W00000XLicensed Practical NursePN153688 M IVOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538521562
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY L MOWRY LPN, QMHS
Provider Business Mailing Address
First Line : 1375 COMMERCE DR
Second Line :
City : NEW LEXINGTON
State : OH
Zip : 43764-9511
Country : US
Telephone Number : 740-342-5154
Fax Number : 740-588-6452
Provider Business Practice Location Address
First Line : 915 S RIVERSIDE DR NE
Second Line :
City : MCCONNELSVILLE
State : OH
Zip : 43756-9102
Country : US
Telephone Number : 740-962-5204
Fax Number : 740-962-3688
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2016
Last Update Date : 04/02/2020

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