Individual
MS. MELODY A FOWLKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
12122 N ROLLING FIELD DR, MEQUON, WI 53097-2766
(262) 242-2283
(262) 242-2156
Mailing address
12122 N ROLLING FIELD DR, MEQUON, WI 53097-2766
(262) 242-2283
(262) 242-2156
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1462-033
WI
363L00000X
Nurse Practitioner
80518-030
WI
Other
Enumeration date
08/20/2006
Last updated
04/23/2008
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