IndividualActive
Mallory Fochtman, CNP
NPI 1104355510 · Women's Health Nurse Practitioner · Bellbrook, OH
Provider details
- NPI number
- 1104355510
- Entity type
- Individual
- Primary specialty
- Women's Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CNP
- Sex
- Female
- Sole proprietor
- No
- License
- APRN.CNP.0035041 (OH)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2006 Cabernet Way
Bellbrook, OH 45305-7502
Phone: (719) 258-0848
Approximate (ZIP-level) locationGet directions
Mailing address
2006 Cabernet Way
Bellbrook, OH 45305-7502
Registry dates
- Enumerated
- 2017-06-08
- Last updated
- 2023-10-01
- Certified
- 2023-10-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.