MALLORY SHAE FOCHTMAN CNP NPI 1104355510

NPI Information

NPI: 1104355510
Provider Name: MALLORY SHAE FOCHTMAN, CNP
Classification: Nurse Practitioner - 363LW0102X
Entity Type: Individual

Specialization: Women's Health

Address:
2006 CABERNET WAY
BELLBROOK, OH
ZIP 45305
Phone: (719) 258-0848
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Mallory Shae Fochtman, CNP is a women's health nurse practitioner in Bellbrook, OH. Mallory Shae Fochtman, CNP NPI is 1104355510. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2006 CABERNET WAY
BELLBROOK, OH
ZIP 45305-502
Phone: (719) 258-0848

The enumeration date for this NPI number is 6/8/2017 and was last updated on 10/1/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LW0102X	Nurse Practitioner	Women's Health	APRN.CNP.0035041	OHIO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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