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NPI Code Detail

MEDICARE: JULIE ANN FOWLER NP

MEDICARE: JULIE ANN FOWLER NP
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
12084P0800XPsychiatry Physician8354CT

General Provider Information

NPI Number : 1174178354
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE ANN FOWLER NP
Provider Business Mailing Address
First Line : 2545 LONG HILL RD
Second Line :
City : GUILFORD
State : CT
Zip : 06437-3616
Country : US
Telephone Number : 203-671-5868
Fax Number :
Provider Business Practice Location Address
First Line : 93 EDWARDS ST
Second Line :
City : NEW HAVEN
State : CT
Zip : 06511-3986
Country : US
Telephone Number : 203-772-1270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2019
Last Update Date : 08/05/2019

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