Provider Demographics
NPI:1043962103
Name:ROWEN, SIMONE E (CNM)
Entity Type:Individual
Prefix:
First Name:SIMONE
Middle Name:E
Last Name:ROWEN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 BELLEVUE AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-4514
Mailing Address - Country:US
Mailing Address - Phone:312-763-1447
Mailing Address - Fax:
Practice Address - Street 1:433 BELLEVUE AVE FL 3
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-4514
Practice Address - Country:US
Practice Address - Phone:312-763-1447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-20
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
176B00000X
CNM07538367A00000X
NJ25ME00077601367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife