Healthcare Provider Details

I. General information

NPI: 1225923030
Provider Name (Legal Business Name): BRITTANY MAE ROWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 NEUROSCIENCE CT
GRAY LA
70359-5209
US

IV. Provider business mailing address

128 NEUROSCIENCE CT
GRAY LA
70359-5209
US

V. Phone/Fax

Practice location:
  • Phone: 985-917-3007
  • Fax: 985-917-3010
Mailing address:
  • Phone: 985-917-3007
  • Fax: 985-917-3010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: