Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Raphael B Fowler, AGPCNP-C

Individual provider Adult Health Nurse Practitioner · NPI 1093519837

Raphael B Fowler, AGPCNP-C is a Nurse Practitioner in Stone Mountain, Georgia. Qualified in 2024, 2 years ago. Licensed in Georgia.

Years since qualifying
2
Licensed in
GA
In the registry since
2025

Practice location Address checks out

4958 Memorial Dr
Stone Mountain, GA 30083-4148
Phone: (678) 542-9756
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence RN276645 (GA)

Record details

NPI number1093519837
Entity typeIndividual (Type 1)
GenderMale
Credentials AGPCNP-C
Sole proprietorNo
NPI enumeratedApril 2, 2025
Last updated in NPPESDecember 8, 2025
Certification dateDecember 8, 2025
Mailing address3387 Peachtree Corners Cir Apt I, Peachtree Corners, GA 30092-4351

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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