Individual
JESSICA LYNN FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
117 PARKVIEW DR, WEIRTON, WV 26062-2375
(304) 479-5577
Mailing address
117 PARKVIEW DR, WEIRTON, WV 26062-2375
(304) 479-5577
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
132347
WV
Other
Enumeration date
06/02/2022
Last updated
06/02/2022
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