Provider Demographics
NPI:1235711664
Name:FOWLER, VALERIE
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:FOWLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 MCINTOSH RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:NH
Mailing Address - Zip Code:03819-3028
Mailing Address - Country:US
Mailing Address - Phone:781-929-7276
Mailing Address - Fax:
Practice Address - Street 1:88 MCINTOSH RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:NH
Practice Address - Zip Code:03819-3028
Practice Address - Country:US
Practice Address - Phone:781-929-7276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA91710164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse