Provider Demographics
NPI:1366827404
Name:BOWEN, JENNIFER L (DNP, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L
Last Name:BOWEN
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1400 HOOPER AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2981
Mailing Address - Country:US
Mailing Address - Phone:908-430-8061
Mailing Address - Fax:732-605-5942
Practice Address - Street 1:1400 HOOPER AVE STE 2
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2981
Practice Address - Country:US
Practice Address - Phone:908-430-8061
Practice Address - Fax:732-605-5942
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2292364363LP0808X
NJ26NJ006593002084P0800X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2292364OtherLICENSE