Individual
MELONY C FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
853 N CHURCH ST, SUITE 620, SPARTANBURG, SC 29303-3098
(864) 573-7511
(864) 560-1690
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
18017
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7006590
—
NC
05
—
NP2131
—
SC
01
—
P01172085
RAILROAD MEDICARE
SC
Enumeration date
09/12/2012
Last updated
01/04/2021
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