Individual
DESTINY A FOWLKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5905 O ST, LINCOLN, NE 68510-2235
(402) 436-1000
Mailing address
5905 O ST, LINCOLN, NE 68510-2235
(402) 436-1000
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
05/25/2022
Last updated
05/25/2022
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