MEDICARE: COLEATHA ZELDA FOWLER FNP

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	363LF0000X	Family Nurse Practitioner	06599	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952698045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLEATHA ZELDA FOWLER FNP

Provider Business Mailing Address
First Line	:	7855 HOWELL BLVD STE 320
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70807-5261
Country	:	US
Telephone Number	:	225-726-2522
Fax Number	:	225-726-2523

Provider Business Practice Location Address
First Line	:	7855 HOWELL BLVD STE 320
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70807-5261
Country	:	US
Telephone Number	:	225-726-2522
Fax Number	:	225-726-2523

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

Provider Enumeration Date	:	07/08/2011
Last Update Date	:	03/18/2026

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