Active NPI
Michelle Marie Fowler, LPN
- Licensed Practical Nurse
- Clintonville, WI
National Provider Identifier
1083276729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 30768-31
- Practice address
- 15 6TH St
Clintonville, WI 54929-1624 - Phone
- (920) 851-8051
- NPI assigned
- Jul 2, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 30768-31 | WI | Primary |
Addresses
Primary practice location
15 6TH St
Clintonville, WI 54929-1624
Mailing address
N9720 State Road 49
Iola, WI 54945-9286
Phone (414) 418-0489
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30768-31 | WI | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562025600000",
"number": "1083276729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N9720 STATE ROAD 49",
"city": "IOLA",
"state": "WI",
"postal_code": "549459286",
"telephone_number": "414-418-0489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 6TH ST",
"city": "CLINTONVILLE",
"state": "WI",
"postal_code": "549291624",
"telephone_number": "920-851-8051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOWLER",
"first_name": "MICHELLE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-02",
"last_updated": "2019-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "WI",
"license": "30768-31",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clintonville, WI
- Fetter Chiropractic SC
- Abbie Laine Fetter, DC
- Five Star Quality Care
- Five Star Quality Care Wi LLC (Greentree Health and Rehabilitation Center)
- Five Star Quality Care Wi LLC (Pine Manor Health Care Center)
- Lesley A Fuerst, NP-C
- Gablian Skills Development LLC
- Leslie Gray, MD
- Griebenow Eyecare, S.C. (Griebenow Eyecare Clintonville)
- Cindy Griswold, NP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.