Healthcare Provider Details

I. General information

NPI: 1184177842
Provider Name (Legal Business Name): MELISSA ROWE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2016
Last Update Date: 11/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 N. HWY. 59
KANSAS OK
74347-0000
US

IV. Provider business mailing address

207 N. HWY. 59
KANSAS OK
74347-0000
US

V. Phone/Fax

Practice location:
  • Phone: 918-786-4434
  • Fax: 918-786-4435
Mailing address:
  • Phone: 918-786-4434
  • Fax: 918-786-4435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: