Individual
MRS. MADRE LYNNELLE FOWLER-MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
615 E LAWSON ST, DURHAM, NC 27701-4533
(919) 604-3734
(616) 620-0671
Mailing address
PO BOX 11091, DURHAM, NC 27703-0091
(919) 604-3734
(919) 620-0671
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
HC3534
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6601596
—
NC
Enumeration date
01/17/2007
Last updated
07/09/2007
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