Healthcare Provider Details

I. General information

NPI: 1679633762
Provider Name (Legal Business Name): JULIE ANNE ROWE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE FLAMMANG

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1113 ALTA AVE SUITE 110
UPLAND CA
91786
US

IV. Provider business mailing address

1038 DEBORAH ST
UPLAND CA
91784-1206
US

V. Phone/Fax

Practice location:
  • Phone: 909-949-8000
  • Fax: 909-920-1111
Mailing address:
  • Phone: 909-982-0187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN 335193 NP 10516
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: