Healthcare Provider Details

I. General information

NPI: 1528364874
Provider Name (Legal Business Name): KIMBERLY ANN ROWLAND RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2011
Last Update Date: 02/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 FANNIE DR
BRIGHTON TN
38011-6287
US

IV. Provider business mailing address

77 FANNIE DR
BRIGHTON TN
38011-6287
US

V. Phone/Fax

Practice location:
  • Phone: 731-439-3328
  • Fax:
Mailing address:
  • Phone: 731-439-3328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN0000156081
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: