Provider Demographics
NPI:1033708896
Name:FOWLER, MONICA LYNN (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:LYNN
Last Name:FOWLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:LYNN
Other - Last Name:METTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4825 DRESSLER RD NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2543
Mailing Address - Country:US
Mailing Address - Phone:330-493-3530
Mailing Address - Fax:330-493-0633
Practice Address - Street 1:4825 DRESSLER RD NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2543
Practice Address - Country:US
Practice Address - Phone:330-493-3530
Practice Address - Fax:330-493-0633
Is Sole Proprietor?:No
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020521650183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist