Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Desaree Fowler, PNP-PC

Individual provider Pediatric Nurse Practitioner · NPI 1124566179

Desaree Fowler, PNP-PC is a Nurse Practitioner in Springville, Utah. Qualified in 2016, 10 years ago. Practices with Revere Health PC, a 410-clinician group and accepts Medicare assignment. Licensed in New Mexico.

Years since qualifying
10
Licensed in
NM
In the registry since
2017

Practice location Address checks out

672 W 400 S Ste 101
Springville, UT 84663-3170
Phone: (801) 491-9883
Fax: (801) 489-3141
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence CNP-03137 (NM)

Record details

NPI number1124566179
Entity typeIndividual (Type 1)
GenderFemale
Credentials PNP-PC
Sole proprietorNo
NPI enumeratedFebruary 9, 2017
Last updated in NPPESOctober 16, 2023
Certification dateOctober 16, 2023
Mailing address1055 N 500 W, Attn. Credentialing, Provo, UT 84604

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Revere Health Pc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Springville