Individual provider · Type 1 NPI
Mallory Shae Fochtman, CNP
Women's Health Nurse Practitioner · Bellbrook, OH
NPI number
1104355510
Active
Practice location
2006 Cabernet Way
Bellbrook, OH 45305-7502
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Women's Health Nurse Practitioner Primary | 363LW0102X | APRN.CNP.0035041 (OH) |
Women's Health Nurse Practitioner: Definition to come...
About NPI 1104355510
Mallory Shae Fochtman, CNP's National Provider Identifier is 1104355510, issued on Jun 8, 2017. The primary taxonomy on file is Women's Health Nurse Practitioner (363LW0102X), and the practice location is in Bellbrook, OH. The record was last updated on Oct 1, 2023.