Provider Demographics
NPI:1073876512
Name:BOWMAN, KRISTEN MICHELLE (MSN, APN)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:MICHELLE
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:MSN, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10950
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89510-0950
Mailing Address - Country:US
Mailing Address - Phone:775-251-3917
Mailing Address - Fax:775-251-3918
Practice Address - Street 1:9790 GATEWAY DR STE 220
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-8923
Practice Address - Country:US
Practice Address - Phone:775-251-3917
Practice Address - Fax:775-251-3918
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN001385363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV112147Medicare PIN