Provider Demographics
NPI:1891214367
Name:FOWLER, KATHERINE (ARNP)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:FOWLER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:RODRIGUEZ ARIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 HOLT AVE # 2727
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4499
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:118 W FAIRBANKS AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4327
Practice Address - Country:US
Practice Address - Phone:407-628-6340
Practice Address - Fax:407-628-6350
Is Sole Proprietor?:No
Enumeration Date:2017-09-15
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9312654363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily