| NPI | 1164082244 |
|---|---|
| Former Name | KIMBERLY M FOWLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 61529) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID 61529) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2019-07-30 |