Provider Demographics
NPI:1235313586
Name:FOWLER, JANE (PA)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:FOWLER
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:301 LIPPINCOTT DR STE 120
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0335
Mailing Address - Fax:856-355-0354
Practice Address - Street 1:200 BOWMAN DR STE E140
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-9631
Practice Address - Country:US
Practice Address - Phone:856-983-4263
Practice Address - Fax:856-983-9362
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2022-06-20
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00096200363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical