Provider Demographics
NPI:1962656751
Name:BOWMAN, KIMBERLY L (RN)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:L
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 WEDGEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-1224
Mailing Address - Country:US
Mailing Address - Phone:732-207-7067
Mailing Address - Fax:
Practice Address - Street 1:169 WEDGEWOOD CIR
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-1224
Practice Address - Country:US
Practice Address - Phone:732-207-7067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR11589700163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management