Individual
JACQLYNE WEBER BOWMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1570 WAVERLY RD, KINGSPORT, TN 37664-2523
(423) 224-1300
(423) 224-1375
Mailing address
1167 SPRATLIN PARK DR, GRAY, TN 37615-6205
(423) 467-3600
(423) 467-3600
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
30297
TN
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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