Provider Demographics
NPI:1841937901
Name:FOWLER, JENNIFER NICOLE (FNP-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:NICOLE
Last Name:FOWLER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8168 HWY 77
Mailing Address - Street 2:
Mailing Address - City:SINTON
Mailing Address - State:TX
Mailing Address - Zip Code:78387-9746
Mailing Address - Country:US
Mailing Address - Phone:361-364-2804
Mailing Address - Fax:361-364-5014
Practice Address - Street 1:8168 HWY 77
Practice Address - Street 2:
Practice Address - City:SINTON
Practice Address - State:TX
Practice Address - Zip Code:78387-9746
Practice Address - Country:US
Practice Address - Phone:361-364-2804
Practice Address - Fax:361-364-5014
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1072190363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily