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CACYCE FOWLER

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1457774200

Individual Registrant:
 CACYCE  FOWLER 
Gender: F
Sole Proprietor

Location and contact information for practice:
108 4TH AVE SW STE A  REFORM, AL 35481 US
Tel: 205-375-6251  Fax: --

Contact information for business:
108 4TH AVE SW STE A  REFORM, AL 35481-8018 US
Tel: 205-375-6251  Fax: 205-375-9064

Registration Information:
NPI: 1457774200
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
AL1-093244

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
MEDICAREA04122AAL01
BCBS OF ALABAMA512-17004AL01




HEALTH CARE JOBS AL - Page 1



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