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General NPI Number Information
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NPI Number | 1255296976
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Entity Type | Individual
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Provider Name | EMILY FOWLER
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Gender | Female
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Dates
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Enumeration Date | 12/16/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 4550 COBB PARKWAY NORTH NW
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City | ACWORTH
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State | GA
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Zip | 30101-4180
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Country | US
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Telephone | 470-956-0050
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Fax |
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Provider Business Mailing Address
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Address Line | 26 HEATHERWOOD TRCE
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City | ACWORTH
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State | GA
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Zip | 30101-5953
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Country | US
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Telephone | 770-757-6160
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN-NP295561
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License Number State | GA
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