Tanya L Fowler, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

193358 Issued in NC

Practice address

313 Walnut St Ste 110
Wilmington, NC 28401-4063

Phone

(910) 668-0268

Fax

(910) 446-8622

NPI assigned

Oct 13, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1697155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1225819394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 KELLY RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284093160",
            "telephone_number": "910-388-4716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 WALNUT ST STE 110",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284014063",
            "telephone_number": "910-668-0268",
            "fax_number": "910-446-8622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "618 Court St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285404752",
            "country_code": "US",
            "telephone_number": "910-668-0268",
            "fax_number": "910-446-8622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "TANYA",
        "middle_name": "L",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-13",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "193358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirsty Fowler
• Lauren Fowler, LCSWA
• Regina Rylee Fowler
• Rian Taylor Fowler, PA-C
• Sandra Y Fowler, LCSW
• Charles Andrew Fox, MD
• Elizabeth Ann Fox, RN
• Jeffrey W. Fox, L.AC.
• Malynda Irene Fox
• Ralph W. Fox II, PH.D.

• Psychiatric/Mental Health Nurse Practitioner in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.