Individual
TINA M FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
327 W SOUTH ST, UNION, SC 29379-2838
(864) 441-0802
(864) 441-0801
Mailing address
327 W SOUTH ST, UNION, SC 29379-2838
(864) 441-0802
(864) 441-0801
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN-TP 18609
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP8444
—
SC
Enumeration date
12/03/2013
Last updated
09/05/2019
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