Provider Demographics
NPI:1851641864
Name:FOWLER, DONNA (DNP, NP-C, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:FOWLER
Suffix:
Gender:F
Credentials:DNP, NP-C, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32446-1917
Mailing Address - Country:US
Mailing Address - Phone:850-482-2910
Mailing Address - Fax:850-428-2836
Practice Address - Street 1:4284 KELSON AVE
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446-2948
Practice Address - Country:US
Practice Address - Phone:850-482-2910
Practice Address - Fax:850-482-2836
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9235871363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily