Healthcare Provider Details

I. General information

NPI: 1851096820
Provider Name (Legal Business Name): SIERRA FOWLER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2023
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 RIVER BEND DR STE A
GRANITE FALLS NC
28630-9390
US

IV. Provider business mailing address

160 RIVER BEND DR STE A
GRANITE FALLS NC
28630-9390
US

V. Phone/Fax

Practice location:
  • Phone: 828-757-5060
  • Fax: 828-757-5068
Mailing address:
  • Phone: 828-757-5060
  • Fax: 828-757-5068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2026-03006
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: