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NPI Code Detail

MEDICARE: HOLLY JOANNE FOWLER RN MSN CDCES

MEDICARE: HOLLY JOANNE FOWLER RN MSN CDCES
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
1163WD0400XDiabetes Educator Registered Nurse1-076221AL

General Provider Information

NPI Number : 1225795818
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY JOANNE FOWLER RN MSN CDCES
Provider Business Mailing Address
First Line : 101 SIVLEY RD SW
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35801-4421
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 101 SIVLEY RD SW
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35801-4421
Country : US
Telephone Number : 256-265-8413
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2021
Last Update Date : 11/18/2021

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