Provider Demographics
NPI:1811500242
Name:FOWLER, JEWELL HILBOURN
Entity type:Individual
Prefix:MRS
First Name:JEWELL
Middle Name:HILBOURN
Last Name:FOWLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 FURNIE HINSON RD
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-4837
Mailing Address - Country:US
Mailing Address - Phone:910-840-1363
Mailing Address - Fax:
Practice Address - Street 1:44 FURNIE HINSON RD
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-4837
Practice Address - Country:US
Practice Address - Phone:910-840-1363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer