Individual ProviderMorgan Baltrus FowlerNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address4420 Lake Boone Trl, Raleigh, NC 27607-7505(919) 784-2676(919) 488-0015PECOS EnrollmentBased on the most recent information from CMS, provider Morgan Baltrus Fowler does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1942681036Provider TypeIndividualFull NameFowler, Morgan BaltrusCredentialCPNP-PCGenderFemaleSole ProprietorNoEnumeration Date6/15/2015Last Updated10/29/2022Contact InformationPractice LocationPractice Address4420 Lake Boone Trl, Raleigh, NC 27607-7505Phone(919) 784-2676FaxUnlisted FaxMailing LocationMailing Address260 Horizon Dr, Raleigh, NC 27615-4922Phone(919) 488-0015Fax(919) 277-0066Provider TaxonomiesCodeDescriptionLicenseCode363LP0200XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense239061North CarolinaCode363LP0200XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense5007725North CarolinaProvider IdentifiersIDDescriptionIssuerID5007725DescriptionOtherIssuerNCBONNorth CarolinaID239061DescriptionOtherIssuerNCBON LICENSE NUMBERNorth Carolina