Connie Bowens, PN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

056762 Issued in MO

Practice address

101 S Main St
Poplar Bluff, MO 63901-5843

Phone

(573) 686-5090

NPI assigned

Apr 6, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Advanced Practice Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southeast Missouri Behavioral Health

  • Adult Mental Health Clinic/Center
  • Farmington, MO
  • NPI 1144372517
  NPD (past)
• Southeast Missouri Behavioral Health Inc

  • Community/Behavioral Health Agency
  • Farmington, MO
  • NPI 1982875407

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1043849672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 459",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636400459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S MAIN ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639015843",
            "telephone_number": "573-686-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWENS",
        "first_name": "CONNIE",
        "credential": "PN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "056762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timberlee Lynne Booth
• Carl Eugene Bosley, D.O.
• Roger Kingsley Bost, MD
• Kyle Demetri Bounds
• Jacob Bowen, PHARMD
• Christian Bowers, APRN
• Kristina Ruth Bowlby
• Jorgia A Bowling, FNP-C
• Sara S. Bowling, LMSW
• Mary Lu Boyer, HIS

• Licensed Practical Nurse in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Licensed Practical Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.