Healthcare Provider Details

I. General information

NPI: 1821870833
Provider Name (Legal Business Name): KRYSTLE U ROWLANDS AGPCNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRYSTLE U ROWLANDS RN

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 05/15/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PARNASSUS AVE STE A2300
SAN FRANCISCO CA
94143-2202
US

IV. Provider business mailing address

215 ALTA LOMA DR
SOUTH SAN FRANCISCO CA
94080-2241
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-2739
  • Fax:
Mailing address:
  • Phone: 650-267-3861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberNP95027113
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberNP95027113
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberNP95027113
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: