Provider Demographics
NPI:1609364967
Name:BOWLIN, KATIE LYNN (MSN, CPNP-PC)
Entity Type:Individual
Prefix:MISS
First Name:KATIE
Middle Name:LYNN
Last Name:BOWLIN
Suffix:
Gender:F
Credentials:MSN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2554 138TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-5206
Mailing Address - Country:US
Mailing Address - Phone:830-719-6090
Mailing Address - Fax:
Practice Address - Street 1:5202 82ND ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-2823
Practice Address - Country:US
Practice Address - Phone:806-725-7337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX880993163W00000X
TX1020419363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse