Provider Demographics
NPI:1902306012
Name:BOWMAN, KIMBERLY D (LPN)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:D
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638-1446
Mailing Address - Country:US
Mailing Address - Phone:740-533-9850
Mailing Address - Fax:740-533-9852
Practice Address - Street 1:611 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-1446
Practice Address - Country:US
Practice Address - Phone:740-533-9850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN156033164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse