Provider Demographics
NPI:1134514516
Name:BLOWE, KIM RENEE (LPN)
Entity Type:Individual
Prefix:MS
First Name:KIM
Middle Name:RENEE
Last Name:BLOWE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:RENEE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4642 LIVINGSTON RD SE
Mailing Address - Street 2:# 303
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-3160
Mailing Address - Country:US
Mailing Address - Phone:240-421-4105
Mailing Address - Fax:
Practice Address - Street 1:6856 EASTERN AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2165
Practice Address - Country:US
Practice Address - Phone:202-545-6980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLPN5971164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse