Provider Demographics
NPI:1174862924
Name:ROWE, DIONE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:DIONE
Middle Name:
Last Name:ROWE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:WINNER
Mailing Address - State:SD
Mailing Address - Zip Code:57580-2604
Mailing Address - Country:US
Mailing Address - Phone:605-842-1465
Mailing Address - Fax:605-842-2366
Practice Address - Street 1:500 E 9TH ST
Practice Address - Street 2:
Practice Address - City:WINNER
Practice Address - State:SD
Practice Address - Zip Code:57580-2604
Practice Address - Country:US
Practice Address - Phone:605-842-1465
Practice Address - Fax:605-842-2366
Is Sole Proprietor?:No
Enumeration Date:2013-02-13
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP000975363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDCP000975OtherCERTIFIED NURSE PRACTITIONER
SDMR3639400OtherCONTROLLED SUBSTANCE CERTIFICATE