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General NPI Number Information
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NPI Number | 1689546004
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Entity Type | Individual
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Provider Name | TAYLOR FOWLER
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Gender | Female
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 1453 E BERT KOUNS INDUSTRIAL LOOP
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City | SHREVEPORT
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State | LA
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Zip | 71105-6800
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Country | US
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Telephone | 318-681-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1805 BEN HOGAN DR
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City | NEW IBERIA
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State | LA
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Zip | 70563-3163
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | LA
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