Individual
MS. ALICIA FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
9660 WICKER AVE, SAINT JOHN, IN 46373-9487
(219) 365-1177
Mailing address
1516 W ASH ST, GRIFFITH, IN 46319-3760
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71008715A
IN
363LF0000X
Family Nurse Practitioner
F10180063
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285182147
—
IN
Enumeration date
11/22/2018
Last updated
09/04/2019
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