Healthcare Provider Details

I. General information

NPI: 1477638450
Provider Name (Legal Business Name): ROBIN E FOWLER LEE MSN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROBIN E MAUER MSN FNP

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 08/22/2022
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 CAMBELL DR
CAMANO ISLAND WA
98282-7377
US

IV. Provider business mailing address

888 CAMBELL DR
CAMANO ISLAND WA
98282-7377
US

V. Phone/Fax

Practice location:
  • Phone: 314-304-3175
  • Fax:
Mailing address:
  • Phone: 314-304-3175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60494705
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: