Provider Demographics
NPI:1871831545
Name:BOWLES, DIANA FRANCES (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:FRANCES
Last Name:BOWLES
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12134 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:KY
Mailing Address - Zip Code:42776-9739
Mailing Address - Country:US
Mailing Address - Phone:270-949-3494
Mailing Address - Fax:270-949-3494
Practice Address - Street 1:12134 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:KY
Practice Address - Zip Code:42776-9739
Practice Address - Country:US
Practice Address - Phone:270-949-3494
Practice Address - Fax:270-949-3494
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8510183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist