Provider Demographics
NPI:1477638450
Name:FOWLER LEE, ROBIN E (MSN FNP)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:E
Last Name:FOWLER LEE
Suffix:
Gender:F
Credentials:MSN FNP
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:E
Other - Last Name:MAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN FNP
Mailing Address - Street 1:888 CAMBELL DR
Mailing Address - Street 2:
Mailing Address - City:CAMANO ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98282-7377
Mailing Address - Country:US
Mailing Address - Phone:314-304-3175
Mailing Address - Fax:
Practice Address - Street 1:888 CAMBELL DR
Practice Address - Street 2:
Practice Address - City:CAMANO ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98282-7377
Practice Address - Country:US
Practice Address - Phone:314-304-3175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60494705363L00000X
MO077146363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2039993Medicaid
WAG8933729Medicare PIN