Individual
MALLORY SHAE FOCHTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2006 CABERNET WAY, BELLBROOK, OH 45305-7502
(719) 258-0848
Mailing address
2006 CABERNET WAY, BELLBROOK, OH 45305-7502
(719) 258-0848
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
APRN.CNP.0035041
OH
Other
Enumeration date
06/08/2017
Last updated
10/01/2023
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