Provider Demographics
NPI:1073627485
Name:ROWLAND, MARIAN WILSON (APN)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:WILSON
Last Name:ROWLAND
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 S OCOEE ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311-2601
Mailing Address - Country:US
Mailing Address - Phone:423-479-5454
Mailing Address - Fax:423-339-3421
Practice Address - Street 1:940 S OCOEE ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-2601
Practice Address - Country:US
Practice Address - Phone:423-479-5454
Practice Address - Fax:423-339-3421
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN128026163WP0808X
IA128935163WP0808X
TN14993363LP0808X
IAG128935363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health