Provider Demographics
NPI:1760627921
Name:BOWDEN, JAN RAQUEL (RN)
Entity type:Individual
Prefix:
First Name:JAN
Middle Name:RAQUEL
Last Name:BOWDEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JAN
Other - Middle Name:RAQUEL
Other - Last Name:KEEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1080 HARVEY BOWDEN RD
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-6774
Mailing Address - Country:US
Mailing Address - Phone:731-336-4080
Mailing Address - Fax:
Practice Address - Street 1:1080 HARVEY BOWDEN RD
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-6774
Practice Address - Country:US
Practice Address - Phone:731-336-4080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4213107163WC0400X
TN0000111269163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management