Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | LG-0000694 | DE |
Y | 363LA2200X | Nurse Practitioner - Adult Health | APRN9267591 | FL |
N | 363LF0000X | Nurse Practitioner - Family Medicine | ARNP9267591 | FL |
N | 363LF0000X | Nurse Practitioner - Family Medicine | LG-0000694 | DE |
NPI | 1003258096 |
---|---|
Provider Name | Ms. Dawn Michelle Fowler |
First Address | Orlando, FL 32806-2002 |
Second Address | Orlando, FL 32806-2002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2013 |
Last Update Date | 29/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
105547300 | (05) | FL |