Individual
JOHNNY S. NOWLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1224 TROTWOOD AVE, COLUMBIA, TN 38401-4802
(931) 380-4017
Mailing address
3419 TANYARD HOLLOW RD, CULLEOKA, TN 38451-2343
(931) 987-2822
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0000000089
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1505420
—
TN
05
—
36630821
—
TN
05
—
3710089
—
TN
05
—
3732438
—
TN
01
—
4186410
BCBST
—
Enumeration date
02/06/2007
Last updated
08/27/2008
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