Most Relevant Information
Provider Data
| NPI Number: | 1003471350 |
| Provider Name: | KIANNA FOWLKES |
| Entity Type: | Individual |
| Taxonomy Code: | 171W00000X |
| Specialty: | Contractor |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/02/2019 |
| Last Updated: | 05/02/2019 |
Provider Practice Location
97 ELMIRA ST SW
WASHINGTON
DC
200322248
Practice Location Phone/Fax
| Phone: | 2026704860 |
| Fax: |
Provider Mailing Location
97 ELMIRA ST SW
WASHINGTON
DC
200322248
Provider Mailing Phone/Fax
| Phone: | 2026704860 |
| Fax: |