Healthcare Provider Details

I. General information

NPI: 1992587828
Provider Name (Legal Business Name): ANTHONY D ROWELL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 10/16/2023
Certification Date: 10/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2807 SW SUMMER CREEK CT
BLUE SPRINGS MO
64015-6266
US

IV. Provider business mailing address

2807 SW SUMMER CREEK CT
BLUE SPRINGS MO
64015-6266
US

V. Phone/Fax

Practice location:
  • Phone: 913-568-8178
  • Fax:
Mailing address:
  • Phone: 913-568-8178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number258522
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number258522
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: