Healthcare Provider Details

I. General information

NPI: 1942065453
Provider Name (Legal Business Name): KAYLA FOWLER ATKISON CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAYLA DANIELLE FOWLER

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 10/19/2025
Certification Date: 10/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 BLACKWELL DAIRY RD
JASPER AL
35504-8406
US

IV. Provider business mailing address

3003 FOREST BRK
NORTHPORT AL
35476-5248
US

V. Phone/Fax

Practice location:
  • Phone: 205-384-4801
  • Fax:
Mailing address:
  • Phone: 205-270-6628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number1-178451
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: