Individual
KELLEY NICOLE FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
270 E COURT AVE, SELMER, TN 38375-2304
(731) 645-7932
(731) 645-5195
Mailing address
115 GRACE THOMAS RD, MICHIE, TN 38357-7042
(731) 610-2643
(731) 645-5195
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
34876
TN
Other
Enumeration date
10/19/2023
Last updated
03/07/2024
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