Provider Demographics
NPI:1528292752
Name:BOWLING, CINDY ANN (RN, PMHNP)
Entity type:Individual
Prefix:MS
First Name:CINDY
Middle Name:ANN
Last Name:BOWLING
Suffix:
Gender:F
Credentials:RN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3795 RIVER RD N
Mailing Address - Street 2:SUITE B
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-4826
Mailing Address - Country:US
Mailing Address - Phone:503-390-0082
Mailing Address - Fax:503-390-0172
Practice Address - Street 1:3795 RIVER RD N
Practice Address - Street 2:SUITE B
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-4826
Practice Address - Country:US
Practice Address - Phone:503-390-0082
Practice Address - Fax:503-390-0172
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-01
Last Update Date:2009-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200950043NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR200950043NPOtherOREGON STATE BOARD OF NURSING