Provider Demographics
NPI:1770916884
Name:FOWLER, JENNIFER (APRN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:FOWLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:SMOTHERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:20375 W 151ST ST
Mailing Address - Street 2:SUITE 350
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-7209
Mailing Address - Country:US
Mailing Address - Phone:913-355-9898
Mailing Address - Fax:913-393-9893
Practice Address - Street 1:20375 W 151ST ST
Practice Address - Street 2:SUITE 350
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-7209
Practice Address - Country:US
Practice Address - Phone:913-355-9898
Practice Address - Fax:913-393-9893
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS76072363LA2200X
KS53-76072-051363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health