Provider Demographics
NPI:1013412139
Name:ROWE, AMANDA YONG (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:YONG
Last Name:ROWE
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 LINDBERG DR STE 14
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-8084
Mailing Address - Country:US
Mailing Address - Phone:985-643-5242
Mailing Address - Fax:985-643-5243
Practice Address - Street 1:1570 LINDBERG DR STE 14
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-8084
Practice Address - Country:US
Practice Address - Phone:985-643-5242
Practice Address - Fax:985-643-5243
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09796363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily