Provider Demographics
NPI:1073395711
Name:FOWLER, EMILY BROOKE (PA-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:BROOKE
Last Name:FOWLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 LOG CABIN RD
Mailing Address - Street 2:
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29340-5428
Mailing Address - Country:US
Mailing Address - Phone:864-764-9233
Mailing Address - Fax:
Practice Address - Street 1:611 5TH AVE W STE B
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4296
Practice Address - Country:US
Practice Address - Phone:828-694-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-17
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant