Provider Demographics
NPI:1710923743
Name:BOWMAN, KATHY (NP)
Entity Type:Individual
Prefix:MS
First Name:KATHY
Middle Name:
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1901 SOLAR DR
Mailing Address - Street 2:SUITE 265
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2641
Mailing Address - Country:US
Mailing Address - Phone:805-278-6840
Mailing Address - Fax:805-278-6838
Practice Address - Street 1:1901 SOLAR DR
Practice Address - Street 2:SUITE 265
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2641
Practice Address - Country:US
Practice Address - Phone:805-278-6840
Practice Address - Fax:508-278-6838
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA474777363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP88585Medicare UPIN