MEDICARE: LESLIE DAWN ROWENS P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA977	NV

General Provider Information

NPI Number	:	1700807286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLIE DAWN ROWENS P.A.

Provider Business Mailing Address
First Line	:	6070 S FORT APACHE ROAD
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5585
Country	:	US
Telephone Number	:	702-307-7941
Fax Number	:	702-307-7907

Provider Business Practice Location Address
First Line	:	6070 S FORT APACHE ROAD
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5585
Country	:	US
Telephone Number	:	702-307-7941
Fax Number	:	702-307-7907

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	07/09/2007

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