Provider Demographics
NPI:1093911505
Name:BOWDEN, JENNIFER (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BOWDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:UNIT 401
Mailing Address - Street 2:11525 KIRBY ST SE
Mailing Address - City:ALTO
Mailing Address - State:MI
Mailing Address - Zip Code:49302-5103
Mailing Address - Country:US
Mailing Address - Phone:616-591-9824
Mailing Address - Fax:616-486-6702
Practice Address - Street 1:7500 GOLDEN OAK TRL SE
Practice Address - Street 2:
Practice Address - City:ALTO
Practice Address - State:MI
Practice Address - Zip Code:49302-9353
Practice Address - Country:US
Practice Address - Phone:616-591-9824
Practice Address - Fax:616-236-0874
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43011113132084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry