Individual
BEVERLY FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
440 US HIGHWAY 84 E, CAIRO, GA 39828-1647
(229) 307-2075
Mailing address
1500 1ST AVE N UNIT 3, BIRMINGHAM, AL 35203-1866
(205) 644-8256
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN196551
GA
Other
Enumeration date
10/23/2020
Last updated
10/23/2020
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