Individual
NANTACHIE MARIE FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2817 ROCK MERRIT AVE, FORT LIBERTY, NC 28310-9692
(910) 907-8922
(910) 907-6069
Mailing address
2817 ROCK MERRIT AVE, FORT LIBERTY, NC 28310-0001
(910) 907-8922
(910) 907-6069
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5005693
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548516669
—
NC
01
—
1739A
BCBSNC
NC
Enumeration date
07/26/2012
Last updated
01/23/2025
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