Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | ARNP753192 | FL |
NPI | 1023048147 |
---|---|
Provider Name | Ms. Laura J Rowe |
First Address | Jacksonville, FL 32216 |
Second Address | Jacksonville, FL 32216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 16/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S94998 | (02) | FL |
Y7730 | BLUE CROSS (01) | FL |