Individual
JESSICA L FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2400 S 48TH ST, SPRINGDALE, AR 72762-6683
(479) 750-2020
(479) 750-4843
Mailing address
2400 S 48TH ST, SPRINGDALE, AR 72762-6683
(479) 750-2020
(479) 750-4843
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R71638
AR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
A004152
AR
Other
Enumeration date
01/11/2011
Last updated
01/19/2017
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