Individual
MS. ELLEN JOY FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1210 W SAGINAW ST, 2ND FLOOR, LANSING, MI 48915-1927
(517) 364-7575
(517) 364-7560
Mailing address
PO BOX 13008, LANSING, MI 48901-3008
(517) 364-6253
(517) 364-6204
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704092592
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5008761270
BCBS INDIVIDUAL PIN
MI
Enumeration date
10/13/2006
Last updated
12/31/2007
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