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NPI Code Detail

MEDICARE: TAMMY MARIE FOWLER

MEDICARE: TAMMY MARIE FOWLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174H00000XHealth Educator

General Provider Information

NPI Number : 1124596671
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMMY MARIE FOWLER
Provider Business Mailing Address
First Line : 597 W 11TH ST
Second Line :
City : PANAMA CITY
State : FL
Zip : 32401-2330
Country : US
Telephone Number : 850-252-9679
Fax Number : 850-461-6200
Provider Business Practice Location Address
First Line : 597 W 11TH ST
Second Line :
City : PANAMA CITY
State : FL
Zip : 32401-2330
Country : US
Telephone Number : 850-252-9679
Fax Number : 850-461-6200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2018
Last Update Date : 11/02/2018

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