Provider Demographics
NPI:1487212718
Name:BOWDEN, NICOLE CABALO (DO)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:CABALO
Last Name:BOWDEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4120 W MEMORIAL RD STE 218
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-9322
Mailing Address - Country:US
Mailing Address - Phone:405-302-2661
Mailing Address - Fax:405-302-2670
Practice Address - Street 1:4120 W MEMORIAL RD STE 218
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-9322
Practice Address - Country:US
Practice Address - Phone:405-302-2661
Practice Address - Fax:405-302-2670
Is Sole Proprietor?:No
Enumeration Date:2019-06-01
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51510135862084N0400X
OK80312084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology