Provider Demographics
NPI:1174352629
Name:FOWLER, DANA CHRISTINA (RN)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:CHRISTINA
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 1:1965 PITTMANTOWN RD
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23438-9468
Mailing Address - Country:US
Mailing Address - Phone:757-642-6450
Mailing Address - Fax:
Practice Address - Street 1:1965 PITTMANTOWN RD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23438-9468
Practice Address - Country:US
Practice Address - Phone:757-642-6450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001212972163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse