Individual
DR. KELLY KOSS BOWLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
205 WABASHA ST S, SAINT PAUL, MN 55107-1805
(651) 293-8100
(651) 293-8106
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
51737
MN
207VG0400X
Gynecology Physician
51737
MN
390200000X
Student in an Organized Health Care Education/Training Program
2005017750- RESIDENT
MO
Other
Enumeration date
06/30/2006
Last updated
12/02/2024
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