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Individual

JASMINE ASHLEY FOWLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
2416 N LOTUS AVE, CHICAGO, IL 60639-1435
(773) 551-2075
Mailing address
2416 N LOTUS AVE, CHICAGO, IL 60639-1435
(773) 551-2075

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209.021989
IL
363LF0000X
Family Nurse Practitioner
209.021989
IL
363LP2300X
Primary Care Nurse Practitioner
Primary
209.021989
IL

Other

Enumeration date
09/15/2020
Last updated
03/23/2021
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