Individual
KRISTA M FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
711 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017
(859) 331-3353
(859) 331-3326
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 331-3353
(859) 331-3326
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3003874
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000262563
ANTHEM PIN
KY
05
—
200459810A
—
IN
05
—
3030562
—
OH
05
—
7100103540
—
KY
01
—
P00912933
RAILROAD MEDICARE
KY
Enumeration date
07/02/2006
Last updated
10/28/2021
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