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Individual

CASEY E FOWLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
215 MCNEEL LN, NORTH PLATTE, NE 69101-6054
(308) 534-6655
(308) 534-6662
Mailing address
215 MCNEEL LN, NORTH PLATTE, NE 69101-6054
(308) 534-6655
(308) 534-6662

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
820
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
273714
MEDICARE
NE
05
47076161613
NE
Enumeration date
08/31/2006
Last updated
12/07/2015
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