Provider Demographics
NPI:1144493073
Name:BOWEN, JENNIFER D (RN)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:D
Last Name:BOWEN
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 1:9900 E SAGEBRUSH DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-7635
Mailing Address - Country:US
Mailing Address - Phone:602-708-3486
Mailing Address - Fax:
Practice Address - Street 1:9900 E SAGEBRUSH DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-7635
Practice Address - Country:US
Practice Address - Phone:602-708-3486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN066961163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant