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General NPI Number Information
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NPI Number | 1912128786
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Entity Type | Individual
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Provider Name | MELANIE COTTIER FOWLER NP
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Gender | Female
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 4710 JEFFERSON ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-2155
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Country | US
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Telephone | 505-955-9454
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Fax | 505-888-9644
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Provider Business Mailing Address
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Address Line | PO BOX 6880
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City | SANTA FE
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State | NM
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Zip | 87502-6880
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Country | US
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Telephone | 505-216-0332
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Fax | 505-982-0279
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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 | AP103778
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | CNP-03354
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License Number State | NM
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