Provider Demographics
NPI:1083598163
Name:FOWLER, DEJA ALIZE (RN)
Entity type:Individual
Prefix:MRS
First Name:DEJA
Middle Name:ALIZE
Last Name:FOWLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8044 MONTGOMERY RD STE 700
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2926
Mailing Address - Country:US
Mailing Address - Phone:513-602-5453
Mailing Address - Fax:
Practice Address - Street 1:8044 MONTGOMERY RD STE 700
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2926
Practice Address - Country:US
Practice Address - Phone:513-549-6814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-02
Last Update Date:2025-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH545245163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse