Healthcare Provider Details

I. General information

NPI: 1780749622
Provider Name (Legal Business Name): SHIRLEY ROWLAND CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9501 LUCY CORR CIR
CHESTERFIELD VA
23832-6697
US

IV. Provider business mailing address

9501 LUCY CORR CIR P. O. BOX 100
CHESTERFIELD VA
23832-6697
US

V. Phone/Fax

Practice location:
  • Phone: 804-751-4385
  • Fax: 804-751-4497
Mailing address:
  • Phone: 804-751-4385
  • Fax: 804-751-4497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number0001126558
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number0024126558
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: