MEDICARE: MS. AMANDA CLAIRE ROWLES RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	2475298	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2475298	OTHER	MN	REGISTERED NURSE

General Provider Information

NPI Number	:	1093377038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMANDA CLAIRE ROWLES RN

Provider Business Mailing Address
First Line	:	510 STATE ROAD 35
Second Line	:
City	:	CENTURIA
State	:	WI
Zip	:	54824-8024
Country	:	US
Telephone Number	:	651-278-2308
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 RIDGEVIEW DR
Second Line	:
City	:	APPLE VALLEY
State	:	MN
Zip	:	55124-9328
Country	:	US
Telephone Number	:	651-278-2308
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2019
Last Update Date	:	03/03/2026

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