Provider Demographics
NPI:1528377132
Name:BOWLES, MARY KATHRYN (LPN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHRYN
Last Name:BOWLES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5861 PAMELEEN CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-6409
Mailing Address - Country:US
Mailing Address - Phone:513-535-9678
Mailing Address - Fax:
Practice Address - Street 1:5861 PAMELEEN CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-6409
Practice Address - Country:US
Practice Address - Phone:513-535-9678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN088812164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse