Healthcare Provider Details

I. General information

NPI: 1861012866
Provider Name (Legal Business Name): AUNKIA FOWLER AND ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2020
Last Update Date: 02/15/2023
Certification Date: 02/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 S BEECH ST
CASPER WY
82601-3106
US

IV. Provider business mailing address

PO BOX 45
EVANSVILLE WY
82636-0045
US

V. Phone/Fax

Practice location:
  • Phone: 307-797-0536
  • Fax: 307-337-1320
Mailing address:
  • Phone: 307-259-6093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: AUNKIA CHRISTINA FOWLER
Title or Position: OWNER
Credential:
Phone: 307-797-0536