Provider Demographics
NPI:1184341869
Name:BOWEN, KRISTEN RENAE (NP)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:RENAE
Last Name:BOWEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:669 HENRY BERRY RD
Mailing Address - Street 2:
Mailing Address - City:ROWLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28383-9129
Mailing Address - Country:US
Mailing Address - Phone:910-506-9967
Mailing Address - Fax:
Practice Address - Street 1:2718 W ROSCOE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-5910
Practice Address - Country:US
Practice Address - Phone:773-961-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCBOWE-CVNKF363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily