Provider Demographics
NPI:1407502248
Name:BOWLING, DIANDRA (APRN)
Entity type:Individual
Prefix:
First Name:DIANDRA
Middle Name:
Last Name:BOWLING
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 HARRODSBURG RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3277
Mailing Address - Country:US
Mailing Address - Phone:855-492-0812
Mailing Address - Fax:859-296-6831
Practice Address - Street 1:1733 HARRODSBURG RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3277
Practice Address - Country:US
Practice Address - Phone:855-492-0812
Practice Address - Fax:859-296-6831
Is Sole Proprietor?:No
Enumeration Date:2022-03-01
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017411363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care