Vickie R Bowen, ASN

Individual provider Active NPI Licensed Practical Nurse · Kingsport, TN

NPI 1467784363 · NPPES record last updated Feb 3, 2010

Key facts

NPI
1467784363
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
0002064803 (VA)
Practice address
1570 Waverly Rd
Kingsport, TN 37664-2523
Phone
(423) 224-1300
NPI assigned
Feb 3, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0002064803VAMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 0002064803 VA Yes

Addresses

Primary practice location

1570 Waverly Rd
Kingsport, TN 37664-2523

Mailing address

1167 Spratlin Park Dr
Gray, TN 37615-6205
Phone (423) 467-3600

Other providers in Kingsport, TN

All providers in Kingsport, TN · Licensed Practical Nurse in Tennessee

Sources for this page

Verify at the official NPI Registry.