Provider Demographics
NPI:1326574625
Name:ROWLAND, KRISTINE KWON (APRN)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:KWON
Last Name:ROWLAND
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 SW WILDWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72713-7564
Mailing Address - Country:US
Mailing Address - Phone:479-531-1260
Mailing Address - Fax:
Practice Address - Street 1:2618 SE J ST
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3767
Practice Address - Country:US
Practice Address - Phone:479-271-9393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-05
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017004789363LA2100X
ARA004843363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care