Provider Demographics
NPI:1568275394
Name:BOWERS, KARLA DALYNNE (LPN)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:DALYNNE
Last Name:BOWERS
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 1:31541 S 618 RD
Mailing Address - Street 2:
Mailing Address - City:GROVE
Mailing Address - State:OK
Mailing Address - Zip Code:74344-6076
Mailing Address - Country:US
Mailing Address - Phone:844-458-2100
Mailing Address - Fax:
Practice Address - Street 1:31541 S 618 RD
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-6076
Practice Address - Country:US
Practice Address - Phone:417-437-1140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKL0027164164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse