MEDICARE: LOUISE FOWLER LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	26NP04588000	NJ

General Provider Information

NPI Number	:	1083888952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUISE FOWLER LPN

Provider Business Mailing Address
First Line	:	1275 SAINT GEORGES AVE BLDG 75
Second Line	:	NORTH HILL APTS. APT # 5C
City	:	COLONIA
State	:	NJ
Zip	:	07067-3934
Country	:	US
Telephone Number	:	800-950-6066
Fax Number	:

Provider Business Practice Location Address
First Line	:	1275 SAINT GEORGES AVE BLDG 75
Second Line	:	NORTH HILL APTS. APT # 5C
City	:	COLONIA
State	:	NJ
Zip	:	07067-3934
Country	:	US
Telephone Number	:	800-950-6066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2008
Last Update Date	:	04/22/2008

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