Basic Information
| Provider Information | |||||||||
| NPI: | 1437251618 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOWMAN | ||||||||
| FirstName: | LAURIE | ||||||||
| MiddleName: | L. | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2330 SHAWNEE MISSION PKWY | ||||||||
| Address2: | MEDICAL ADMINISTRATIVE SERVICES OF KU MED. STE 312 | ||||||||
| City: | WESTWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662052005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135889000 | ||||||||
| FaxNumber: | 9135889822 | ||||||||
| Practice Location | |||||||||
| Address1: | 3901 RAINBOW BLVD | ||||||||
| Address2: | PROFESSIONAL SERVICES OF KU HOSPITAL | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 661600001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135886504 | ||||||||
| FaxNumber: | 9135889104 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2006 | ||||||||
| LastUpdateDate: | 11/07/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 45660 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 364SE0003X | 45660 | KS | N | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Emergency |
ID Information
| ID | Type | State | Issuer | Description | 200271070B | 05 | KS | MEDICAID | 925343 | 01 | FIRSTGUARD | OTHER | P00264542 | 01 | RR MEDICARE | OTHER | 10001783300 | 01 | CHP PROVIDER NUMBER | OTHER | 427274709 | 05 | MO | MEDICAID | 481202402 | 01 | PSKU TAX ID | OTHER |