Individual
JACOB FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1575 DELUCCHI LN STE 114, RENO, NV 89502-6581
(775) 432-1223
Mailing address
1575 DELUCCHI LN STE 114, RENO, NV 89502-6581
(775) 432-1223
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN83672
NV
Other
Enumeration date
01/04/2024
Last updated
01/04/2024
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