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

Mallory Shae Fochtman, CNP

Individual provider Women's Health Nurse Practitioner · NPI 1104355510

Mallory Shae Fochtman, CNP is a Women's Health Nurse Practitioner in Bellbrook, Ohio. Licensed in Ohio. Registered with an NPI since 2017.

Licensed in
OH
In the registry since
2017
What do these letters mean?
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

See every abbreviation used in this directory →

Practice location Address checks out

2006 Cabernet Way
Bellbrook, OH 45305-7502
Phone: (719) 258-0848
Show map & directions

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

Specialties & licences

Women's Health Nurse Practitioner (primary) Taxonomy 363LW0102X · Licence APRN.CNP.0035041 (OH)

Record details

NPI number1104355510
Entity typeIndividual (Type 1)
GenderFemale
Credentials CNP
Sole proprietorNo
NPI enumeratedJune 8, 2017
Last updated in NPPESOctober 1, 2023
Certification dateOctober 1, 2023