Individual
TERESA A FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2716 W CENTRAL AVE, WICHITA, KS 67203-4904
(316) 660-7300
(316) 660-1928
Mailing address
271 W 3RD ST N STE 600, WICHITA, KS 67202-1223
(316) 660-7600
(316) 941-5075
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
43348
KS
Other
Enumeration date
07/22/2020
Last updated
07/22/2020
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