Provider Demographics
NPI:1982730917
Name:BOWEN, ALLISON FIELDS (APRN)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:FIELDS
Last Name:BOWEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:FIELDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2700 STANLEY GAULT PKWY STE 129
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5176
Mailing Address - Country:US
Mailing Address - Phone:502-253-4900
Mailing Address - Fax:502-489-5751
Practice Address - Street 1:1023 NEW MOODY LN STE 201
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-9181
Practice Address - Country:US
Practice Address - Phone:502-225-5520
Practice Address - Fax:502-225-5522
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005014363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100022190Medicaid
KY50027831OtherPASSPORT ADVANTAGE
KY50027831OtherPASSPORT HEALTH PLAN
KYP00755081OtherMEDICARE RR
000000512228OtherANTHEM
KY0783903Medicare PIN
KY0637747Medicare PIN
KY50027831OtherPASSPORT ADVANTAGE
KY50027831OtherPASSPORT HEALTH PLAN
KY0538681Medicare PIN
KY0538784Medicare PIN
KY0538496Medicare PIN