Healthcare Provider Details

I. General information

NPI: 1114722345
Provider Name (Legal Business Name): AMY MARIE ROWAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13306 A ST
OMAHA NE
68144-3660
US

IV. Provider business mailing address

4808 S 60TH ST
OMAHA NE
68117-1620
US

V. Phone/Fax

Practice location:
  • Phone: 402-339-7727
  • Fax:
Mailing address:
  • Phone: 402-637-6522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number45681
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: