Provider Demographics
NPI:1093701013
Name:BOWER, JINNA-LEE (RN ARNP)
Entity Type:Individual
Prefix:
First Name:JINNA-LEE
Middle Name:
Last Name:BOWER
Suffix:
Gender:F
Credentials:RN ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 SEQUOYAH TRL
Mailing Address - Street 2:
Mailing Address - City:CADIZ
Mailing Address - State:KY
Mailing Address - Zip Code:42211-6226
Mailing Address - Country:US
Mailing Address - Phone:270-522-5905
Mailing Address - Fax:
Practice Address - Street 1:241 SEQUOYAH TRL
Practice Address - Street 2:
Practice Address - City:CADIZ
Practice Address - State:KY
Practice Address - Zip Code:42211-6226
Practice Address - Country:US
Practice Address - Phone:270-522-5905
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011P363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health