Provider Demographics
NPI:1114110475
Name:FOWLER, JENNIFER BARRY (APN-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BARRY
Last Name:FOWLER
Suffix:
Gender:F
Credentials:APN-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LEIGH
Other - Last Name:BARRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:170D E MAIN ST # 131
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-2520
Mailing Address - Country:US
Mailing Address - Phone:615-504-3728
Mailing Address - Fax:615-431-2733
Practice Address - Street 1:211 COOL SPRINGS BLVD
Practice Address - Street 2:SUITE 420
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-7242
Practice Address - Country:US
Practice Address - Phone:615-778-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13179363L00000X
TN162664163W00000X
MSR872962163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse