Individual
NICOLE FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1640 G ST, SPRINGFIELD, OR 97477-4226
(541) 682-3550
Mailing address
34659 MATTHEWS RD, EUGENE, OR 97405-9656
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227624
—
OR
Enumeration date
09/21/2006
Last updated
07/08/2007
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