Provider Demographics
NPI:1144376518
Name:ROWLAND, LESLIE A (RN)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:A
Last Name:ROWLAND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:LESLIE
Other - Middle Name:A
Other - Last Name:HORSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:320 S 3RD AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-5048
Mailing Address - Country:US
Mailing Address - Phone:605-339-0420
Mailing Address - Fax:605-339-0038
Practice Address - Street 1:320 S 3RD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-5048
Practice Address - Country:US
Practice Address - Phone:605-339-0420
Practice Address - Fax:605-339-0038
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR034855163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5350183Medicaid