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Individual

CORINNE ALISA FOWLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
621 W MADRONE ST, ROSEBURG, OR 97470-3090
(541) 440-3532
(541) 440-3554
Mailing address
PO BOX 1121, ROSEBURG, OR 97470-0254
(541) 672-2691

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201030437LPN
OR
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
06/20/2022
Last updated
06/20/2022
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