Healthcare Provider Details

I. General information

NPI: 1932215449
Provider Name (Legal Business Name): SHERRI KATHLEEN ROWELL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 12/06/2022
Certification Date: 12/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 E STONER AVE
SHREVEPORT LA
71101-4243
US

IV. Provider business mailing address

55 WINCHESTER CIR
MONROE LA
71203-6626
US

V. Phone/Fax

Practice location:
  • Phone: 318-343-6100
  • Fax:
Mailing address:
  • Phone: 313-345-5649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN056494-SP03862
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN056494-AP03862
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: