Individual
MS. ELIZABETH ROSE FOWLKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
987400 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-7400
(402) 559-6673
(402) 559-8333
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
(402) 559-6673
(402) 559-8333
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002181
IA
363AM0700X
Medical Physician Assistant
1501
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871811729
WELLMARK BCBS OF IA
IA
Enumeration date
05/16/2010
Last updated
06/08/2016
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