Individual
MS. DARETH ELIZABETH FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
709 DEERFIELD TRL, SPRINGFIELD, OH 45503-7445
(614) 746-0440
Mailing address
709 DEERFIELD TRL, SPRINGFIELD, OH 45503-7445
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN.NP.024987
OH
363LG0600X
Gerontology Nurse Practitioner
APRN.NP.024987
OH
Other
Enumeration date
08/28/2019
Last updated
12/06/2023
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