Healthcare Provider Details

I. General information

NPI: 1710163399
Provider Name (Legal Business Name): LISA ANN ROWLEY RN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 11/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 BELMONT AVE SUITE 2300
YOUNGSTOWN OH
44504-1131
US

IV. Provider business mailing address

1340 BELMONT AVE SUITE 2300
YOUNGSTOWN OH
44504-1131
US

V. Phone/Fax

Practice location:
  • Phone: 330-746-1488
  • Fax: 330-746-5611
Mailing address:
  • Phone: 330-746-1488
  • Fax: 330-746-5611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number215708
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number09830NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: