Individual
CACYCE FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
108 4TH AVE SW STE A, REFORM, AL 35481
(205) 375-6251
Mailing address
108 4TH AVE SW STE A, REFORM, AL 35481-8018
(205) 375-6251
(205) 375-9064
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-093244
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
512-17004
BCBS OF ALABAMA
AL
01
—
A04122A
MEDICARE
AL
Enumeration date
01/30/2014
Last updated
11/13/2019
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