Provider Demographics
NPI:1548618937
Name:BOWMAN, CATHLEEN PENNY MONICA (FNP)
Entity Type:Individual
Prefix:MISS
First Name:CATHLEEN
Middle Name:PENNY MONICA
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2363 N 47TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-2923
Mailing Address - Country:US
Mailing Address - Phone:414-975-9216
Mailing Address - Fax:
Practice Address - Street 1:1555 N RIVERCENTER DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-3981
Practice Address - Country:US
Practice Address - Phone:414-223-4847
Practice Address - Fax:414-231-1092
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-26
Last Update Date:2016-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI145760-30163W00000X
WI6910-33363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care