Provider Demographics
NPI:1437518180
Name:FOWLER, MARIANNE GREER (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:GREER
Last Name:FOWLER
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Gender:F
Credentials:APRN, FNP-C
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Mailing Address - Street 1:1720 E REELFOOT AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-6047
Mailing Address - Country:US
Mailing Address - Phone:731-885-6600
Mailing Address - Fax:731-885-9239
Practice Address - Street 1:1720 E. REELFOOT AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-6048
Practice Address - Country:US
Practice Address - Phone:731-885-6600
Practice Address - Fax:731-885-9239
Is Sole Proprietor?:No
Enumeration Date:2016-02-22
Last Update Date:2017-04-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN20901363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ022493Medicaid
TN448944Medicare PIN