Basic Information
Provider Information
NPI: 1487093449
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FOWLER
FirstName: KATHERINE
MiddleName: FRITSCHE
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: FRITSCHE
OtherFirstName: KATHERINE
OtherMiddleName: L
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: CRNA
OtherLastNameType: 1
Mailing Information
Address1: 1431 CENTERPOINT BLVD
Address2: SUITE 100
City: KNOXVILLE
State: TN
PostalCode: 379321984
CountryCode: US
TelephoneNumber: 8659857024
FaxNumber: 8659857079
Practice Location
Address1: 1 TAMPA GENERAL CIR
Address2:  
City: TAMPA
State: FL
PostalCode: 336063571
CountryCode: US
TelephoneNumber: 8138447677
FaxNumber: 8138444972
Other Information
ProviderEnumerationDate: 06/22/2013
LastUpdateDate: 04/05/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XARNP 9255424FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


Home