Individual
JEANA KELLY FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN/ADM
Contact information
Practice address
1449 W MAIN, PAWHUSKA, OK 74056
(918) 287-5645
(918) 287-5572
Mailing address
3329 WOOTEN RD, BURBANK, OK 74633
(918) 287-7279
(918) 287-5572
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
D6079682
OK
163WH0200X
Home Health Registered Nurse
Primary
D6079682
OK
Other
Enumeration date
08/10/2006
Last updated
09/11/2025
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