Jaden Ivory Fowler, BSN RN CCRN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704338945 Issued in MI

Practice address

43117 Chaucer CT
Sterling Heights, MI 48313-1830

Phone

(248) 514-0320

NPI assigned

Aug 31, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1558081331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43117 CHAUCER CT",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483131830",
            "telephone_number": "248-514-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43117 CHAUCER CT",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483131830",
            "telephone_number": "248-514-0320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "JADEN",
        "middle_name": "IVORY",
        "credential": "BSN RN CCRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704338945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Foster, D.O.
• Nicole Marie Foster, PT
• Ryan Foster
• Four Star Center LLC
• Erica Machelle Shata Foutner
• Jamila Breanna Lauren Fowler
• Marwan J Francess, MOT, OTR
• Frank Rosner, D.D.S., P.C.
• Frank T. Petruzzello, D.D.S., P.C.
• Elaine Frank, M.ED., R.D.

• Registered Nurse in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.