Doctor Name: | MELISSA FOWLER |
NPI Number: | 1043676422 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSN, BSN, APRN, AGNP |
License Number: | 20881 |
Business Practice Address: | 529 W Commerce St Lewisburg, TN - 370913219 |
Business Phone Number: | 9312709729 |
Business Fax Number: | |
Mailing Address: | 529 W Commerce St, LEWISBURG |
State: | TN |
Postal Code: | 370913219 |
Phone Number: | 9312709729 |
Fax Number: | |
NPI Enumeration Date: | 01/14/2016 |
NPI Last Update Date: | 01/14/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 20881 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |