Provider Demographics
NPI:1023402682
Name:FOWLER, KATHRYN (RPH)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:FOWLER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3880 N 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2802
Mailing Address - Country:US
Mailing Address - Phone:850-444-4929
Mailing Address - Fax:
Practice Address - Street 1:3880 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2802
Practice Address - Country:US
Practice Address - Phone:850-444-4929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-22
Last Update Date:2015-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS45982183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist