Healthcare Provider Details

I. General information

NPI: 1073457628
Provider Name (Legal Business Name): ROWAN ROSEWARNE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 LOMAS BLVD NE
ALBUQUERQUE NM
87106-2719
US

IV. Provider business mailing address

9100 SAN MATEO BLVD NE APT 2017
ALBUQUERQUE NM
87113-2603
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-2111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License NumberRP00010325
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: