Individual
MARISSA FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
12265 SHIOH DR, CHESTERLAND, OH, OH 44026
(440) 665-9274
Mailing address
150 CENTER ST, CHARDON, OH 44024-1179
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.0030311
OH
Other
Enumeration date
11/22/2021
Last updated
03/16/2023
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