Provider Demographics
NPI:1295172708
Name:BOWLING, KENDRA DAWN (STNA)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:DAWN
Last Name:BOWLING
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:847 US 52
Mailing Address - Street 2:ROOM 7
Mailing Address - City:ABERDEEN
Mailing Address - State:OH
Mailing Address - Zip Code:45101-1102
Mailing Address - Country:US
Mailing Address - Phone:513-535-4910
Mailing Address - Fax:
Practice Address - Street 1:847 US 52
Practice Address - Street 2:ROOM 7
Practice Address - City:ABERDEEN
Practice Address - State:OH
Practice Address - Zip Code:45101-1102
Practice Address - Country:US
Practice Address - Phone:513-535-4910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-24
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401488430213374U00000X, 376J00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker