Individual
BROOKE M FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2253 W MASON ST, GREEN BAY, WI 54303
(920) 468-8288
Mailing address
2253 W MASON ST, GREEN BAY, WI 54303-4706
(920) 468-8288
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8596
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100080610
—
WI
Enumeration date
08/06/2018
Last updated
08/14/2024
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