Provider Demographics
NPI:1972298255
Name:BOWENS, NAKIA LEE (RN)
Entity Type:Individual
Prefix:
First Name:NAKIA
Middle Name:LEE
Last Name:BOWENS
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 1:2419 SHELBY ST APT 30
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46203-4267
Mailing Address - Country:US
Mailing Address - Phone:317-560-1865
Mailing Address - Fax:
Practice Address - Street 1:4229 N COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-1929
Practice Address - Country:US
Practice Address - Phone:317-560-1865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28201673A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse