Lisa Rachelle Fowles PA

NPI 1760887376 - Physician Assistant - 363A00000X

NPI Details
NPI 1760887376
Gender Female
Enumeration Date 10/24/2014
Last Updated 09/23/2015
Entity Type Individual
Active Over 2 years ago
Practice Location
11005 VISTAZO
ALBUQUERQUE NM, 87123-5993, US
Phone (505) 554-7545
Fax
Business Location
11005 VISTAZO
ALBUQUERQUE NM, 87123-5993, US
Phone (505) 554-7545
Fax
Toxanomy
Taxonomy Code 363A00000X
License State New Mexico
License Number 134524022
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According to our database, Lisa Rachelle Fowles PA NPI is 1760887376, taxonomy code is 363A00000X and license number is 134524022, license state is located at New Mexico. Lisa Rachelle Fowles PA physically located at 11005 Vistazo, Albuquerque NM, 87123-5993. NPI Number Lisa Rachelle Fowles PA has the Individual type.

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1760887376 NPI number is provided on an as is basis without warranty of any kind. 1760887376 is maintained by the National Plan & Provider Enumeration System. The contents of Lisa Rachelle Fowles PA are for informational purposes only.