Provider Demographics
NPI:1174759369
Name:BOWIE, KIMBERLEY JEAN (LPN)
Entity type:Individual
Prefix:MISS
First Name:KIMBERLEY
Middle Name:JEAN
Last Name:BOWIE
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 1:12730 WHITTINGTON DR
Mailing Address - Street 2:604
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-4745
Mailing Address - Country:US
Mailing Address - Phone:281-271-8514
Mailing Address - Fax:346-207-8514
Practice Address - Street 1:12730 WHITTINGTON DR
Practice Address - Street 2:604
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-4745
Practice Address - Country:US
Practice Address - Phone:281-271-8514
Practice Address - Fax:346-207-8514
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 133093164W00000X
TX225873164W00000X, 174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No174H00000XOther Service ProvidersHealth Educator