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Individual
JENNIFER FOWLKES
Active
Individual
JENNIFER FOWLKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP, FNP-C
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R177755
MD
363LF0000X
Family Nurse Practitioner
Primary
R177755
MD
Other
Enumeration date
10/21/2014
Last updated
09/15/2021
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