Provider Demographics
NPI:1225543226
Name:ROLWES, MARIA GIUBARDO (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:GIUBARDO
Last Name:ROLWES
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:MICHELLE
Other - Last Name:GIUBARDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1008 S SPRING AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-2520
Mailing Address - Country:US
Mailing Address - Phone:314-977-4740
Mailing Address - Fax:314-977-1642
Practice Address - Street 1:3655 VISTA AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110
Practice Address - Country:US
Practice Address - Phone:314-577-8773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017040112363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care