Healthcare Provider Details

I. General information

NPI: 1326442427
Provider Name (Legal Business Name): CHRISTINE ROWE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 10/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1014 AUTUMN RD SUITE 4
LITTLE ROCK AR
72211-3704
US

IV. Provider business mailing address

1014 AUTUMN RD SUITE 4
LITTLE ROCK AR
72211-3704
US

V. Phone/Fax

Practice location:
  • Phone: 501-221-1941
  • Fax: 501-224-1340
Mailing address:
  • Phone: 501-221-1941
  • Fax: 501-224-1340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberR043755
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: