DR. KELLY KOSS BOWLIN (NPI# 1477582880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1477582880 |
Entity Type | Individual |
Full Name | DR. KELLY KOSS BOWLIN |
Other Name | DR. KELLY MARIE BOWLIN |
Credential | D.O. |
Practice Address |
205 Wabasha St S Saint Paul MN 55107-1805 |
Mailing Address |
8170 33rd Ave S Po Box 1309 Mail Stop 21110q Minneapolis MN 55425-4516 |
Practice Telephone | 6512938100 |
Practice Fax Number | 6512938106 |
Enumeration Date | 2006-06-30 |
Last Update Date | 2018-09-24 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
51737 | MN | Allopathic & Osteopathic Physicians |
N | 390200000X | Student in an Organized Health Care Education/Training Program | 2005017750- RESI | MO | Student, Health Care |
Address | Telephone Number | Fax Number |
---|---|---|
14000 Fairview Dr, Burnsville, MN 553375713 | 9529938693 |
Street Address |
205 WABASHA ST S |
City | SAINT PAUL |
State | MN |
Zip Code | 55107-1805 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730184078 | Chokchai Chareandee | Internal Medicine | 205 Wabasha St S, Saint Paul, MN 55107-1805 | 2005-06-14 |
1699334904 | Jessica Determan | Nurse Practitioner | 205 Wabasha St S, Saint Paul, MN 55107-1805 | 2019-06-10 |
1326517541 | Julian Andres Larrea Saavedra | Physician Assistant | 205 Wabasha St S, Saint Paul, MN 55107-1805 | 2018-11-16 |
1053818252 | Mackenzie Thayer | Student in an Organized Health Care Education/Training Program | 205 Wabasha St S, Saint Paul, MN 55107-1805 | 2018-04-12 |
1215436076 | Mardiya Kassim Jaffer | Nurse Practitioner | 205 Wabasha St S, Saint Paul, MN 55107-1805 | 2018-02-07 |
1023522877 | Samantha Zarske | Physician Assistant | 205 Wabasha St S, Saint Paul, MN 55107-1805 | 2017-11-30 |
1184134173 | Ghada Elnashar | Pharmacist | 205 Wabasha St S, Saint Paul, MN 55107-1805 | 2017-10-04 |
1972022267 | Allison Brooks | Nurse Practitioner | 205 Wabasha St S, Saint Paul, MN 55107-1805 | 2017-09-18 |
1982132536 | Erin Galegher | Advanced Practice Midwife | 205 Wabasha St S, Saint Paul, MN 55107-1805 | 2017-05-26 |
1679016000 | Juliana Huber | Nurse Practitioner | 205 Wabasha St S, Saint Paul, MN 55107-1805 | 2016-12-03 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477944809 | Marina Castillo | Counselor | 143 Isabel St. W, Saint Paul, MN 55107 | 2015-02-06 |
1134540123 | Michelle M Lee | Social Worker | 106 Water Street/3rd Floor, Umbrella Tree Studios, St. Paul, MN 55107 | 2013-12-18 |
1376748574 | Mary E. A. Horoshak | Physical Therapist | 155 S Wabasha St, Suite 130, St. Paul, MN 55107 | 2007-06-18 |
1821156050 | Amherst H. Wilder Foundation | Assisted Living Facility | 469 Ada St, Saint Paul, MN 55107 | 2006-12-04 |
1407914674 | Amherst H. Wilder Foundation | Clinic/Center | 516 Humboldt Ave, Saint Paul, MN 55107 | 2006-12-04 |
1780753681 | Chad Randal Vickers | Nurse Practitioner | 135 Colorado Street East, Saint Paul, MN 55107 | 2006-11-06 |
1225122872 | Elizabeth E Frost | Family Medicine | 153 Cesar Chavez Street, St Paul, MN 55107 | 2006-10-03 |
1619413606 | Elizabeth Burgos | Social Worker | 153 Cesar Chavez St, Saint Paul, MN 55107 | 2017-01-13 |
1033561915 | Isetta Pierre | Marriage & Family Therapist | 153 Cesar Chavez St, Saint Paul, MN 55107 | 2016-07-05 |
1366819609 | Brittany Leach | Advanced Practice Midwife | 624 Smith Ave S, Saint Paul, MN 55107 | 2015-08-21 |
Find all providers in zip 55107 |
Taxonomy Code | 207VG0400X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Obstetrics & Gynecology |
Specialization | Gynecology |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609028521 | William Meyer | Obstetrics & Gynecology | 6517 Cherokee Trl, Edina, MN 55439-1108 | 2008-10-22 |
1083658181 | Kimberly Anne Gerten | Obstetrics & Gynecology | 6565 France Ave S Ste 200, Edina, MN 55435-2141 | 2006-06-16 |
1568401313 | Jerald W Reinhardt | Obstetrics & Gynecology | 1428 Central Ave Ne, East Grand Forks, MN 56721-1605 | 2006-06-06 |
1255339883 | Kenneth M Palmer | Obstetrics & Gynecology | 1650 4th St Se, Rochester, MN 55904-4717 | 2005-07-08 |
1740286400 | Susan Joyce Cushman | Obstetrics & Gynecology | 14001 Ridgedale Dr, Ste 200, Minnetonka, MN 55305-1753 | 2005-06-27 |
1114333754 | Fairview Health Services | Obstetrics & Gynecology | 7450 France Ave S, Suite 240, Edina, MN 55435-4792 | 2014-07-03 |
1457648065 | Marie C Nelson | Obstetrics & Gynecology | 811 2nd St Se, Little Falls, MN 56345-3559 | 2011-07-03 |
1770878928 | Jill A Moes | Obstetrics & Gynecology | 200 1st St Sw, Rochester, MN 55905-0001 | 2011-06-16 |
1427366814 | Leigh F Bauer | Obstetrics & Gynecology | 320 E Main St, Ob/gyn Dept, Crosby, MN 56441-1645 | 2010-09-20 |
1649398546 | Women's Health & Laser Aesthetic Center, LLC | Obstetrics & Gynecology | 7250 France Ave S, Suite 102, Edina, MN 55435-4305 | 2007-03-27 |
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City | SAINT PAUL |
Zip Code | 55107 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.