Provider Demographics
NPI:1205005212
Name:ROWLAND, ANNITA JEANNE (FNP)
Entity Type:Individual
Prefix:
First Name:ANNITA
Middle Name:JEANNE
Last Name:ROWLAND
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37821-3809
Mailing Address - Country:US
Mailing Address - Phone:423-237-6341
Mailing Address - Fax:
Practice Address - Street 1:1907 W MORRIS BLVD
Practice Address - Street 2:SUITE 300A
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-3860
Practice Address - Country:US
Practice Address - Phone:423-353-1152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-23
Last Update Date:2020-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13280363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3341697Medicaid
TN4182490OtherBCBS
TN4182490OtherBCBS