Provider Demographics
NPI:1376945527
Name:BOWMAN, KERRY E (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:KERRY
Middle Name:E
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-2813
Mailing Address - Country:US
Mailing Address - Phone:518-828-9469
Mailing Address - Fax:518-828-0927
Practice Address - Street 1:617 WARREN ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-2813
Practice Address - Country:US
Practice Address - Phone:518-828-9469
Practice Address - Fax:518-828-0927
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057072183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist