Fara Moore Fowler, RNC
Registered Nurse, Psych/Mental Health, Adult in Conway, SC. Individual provider (NPI-1).
NPI number1174545321
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1174545321
- Entity type
- Individual (NPI-1)
- Name
- Fara Moore Fowler
- Credential
- RNC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 24, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WP0809X | Registered Nurse, Psych/Mental Health, Adult | 00026004 | SC | Yes |
Practice location
164 Waccamaw Medical Park DrConway, SC 29526-8903
Phone 843-347-5060
Mailing address
121 Clemson RdConway, SC 29526-8830
Phone 843-347-6564
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