Provider Demographics
NPI:1386637445
Name:ROWLAND, DENNIS L (NP)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:L
Last Name:ROWLAND
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1937 BRIAR RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-5963
Mailing Address - Country:US
Mailing Address - Phone:662-690-4305
Mailing Address - Fax:662-690-5736
Practice Address - Street 1:1937 BRIAR RIDGE RD
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-5963
Practice Address - Country:US
Practice Address - Phone:662-690-4200
Practice Address - Fax:662-690-5736
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR852361363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSS46390Medicare UPIN