MEDICARE: JENNIFER BOWMAN RN, BSN

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	163WG0000X	General Practice Registered Nurse	RN-79442	NM

General Provider Information

NPI Number	:	1891673703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER BOWMAN RN, BSN

Provider Business Mailing Address
First Line	:	41 WHITE OAK DR
Second Line	:
City	:	CONWAY
State	:	AR
Zip	:	72034-3443
Country	:	US
Telephone Number	:	505-206-2908
Fax Number	:

Provider Business Practice Location Address
First Line	:	41 WHITE OAK DR
Second Line	:
City	:	CONWAY
State	:	AR
Zip	:	72034-3443
Country	:	US
Telephone Number	:	505-206-2908
Fax Number	:

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

Provider Enumeration Date	:	08/27/2025
Last Update Date	:	08/27/2025

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