Individual
DANIELLE FOWERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
304 W WASHINGTON AVE, RICHLAND, MO 65556-7101
(877) 406-2662
Mailing address
PO BOX 777, RICHLAND, MO 65556-0777
(877) 406-2662
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2020016680
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420090398
—
MO
Enumeration date
11/06/2020
Last updated
05/16/2022
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