Healthcare Provider Details

I. General information

NPI: 1316006406
Provider Name (Legal Business Name): PAMELA ROWLAND RN,CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 04/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 RIDGWAY RD
PINE BLUFF AR
71603-7611
US

IV. Provider business mailing address

1301 RIDGWAY RD
PINE BLUFF AR
71603-7611
US

V. Phone/Fax

Practice location:
  • Phone: 870-663-0799
  • Fax: 870-292-3443
Mailing address:
  • Phone: 870-663-0799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN121496
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: