Corinne Alisa Fowler

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

201030437LPN Issued in OR

Practice address

621 W Madrone St
Roseburg, OR 97470-3090

Phone

(541) 440-3532

Fax

(541) 440-3554

NPI assigned

Jun 20, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1699406710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1121",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974700254",
            "telephone_number": "541-672-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 W MADRONE ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703090",
            "telephone_number": "541-440-3532",
            "fax_number": "541-440-3554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "671 SW Main St",
            "address_purpose": "LOCATION",
            "city": "Winston",
            "state": "OR",
            "postal_code": "974966571",
            "country_code": "US",
            "telephone_number": "541-492-4550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "CORINNE",
        "middle_name": "ALISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OR",
            "license": "201030437LPN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Forget Me Not Family Care Home (Forget Me Not Village)
• Devan Fors
• Dylan Fors, PT
• Mary Therese Fortier, LCSW
• Samantha Marie Foster-Pratt
• Nicholas Jon Fowler, AUD
• Rachael Fowler
• Nicki Golden Fox-Morse
• Dawn Ann Fox, CADC I
• Frances C Munkenbeck MD PC

• Licensed Practical Nurse in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Licensed Practical Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.