Individual
PAMELA JO FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2510 LAKELAND DR, FLOWOOD, MS 39232-9513
(601) 355-1234
(601) 326-3559
Mailing address
2510 LAKELAND DR, FLOWOOD, MS 39232-9513
(601) 355-1234
(601) 326-3559
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R593044
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04825050
—
MS
01
—
P00872456
RR MEDICARE
MS
Enumeration date
03/12/2008
Last updated
11/02/2017
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