Provider Demographics
NPI:1407082910
Name:ROWELL, BERENICE M (MIDWIFE)
Entity Type:Individual
Prefix:MRS
First Name:BERENICE
Middle Name:M
Last Name:ROWELL
Suffix:
Gender:F
Credentials:MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 MYRTLE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-5632
Mailing Address - Country:US
Mailing Address - Phone:813-949-1185
Mailing Address - Fax:813-949-1162
Practice Address - Street 1:106 MYRTLE RIDGE RD
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-5632
Practice Address - Country:US
Practice Address - Phone:813-949-1185
Practice Address - Fax:813-949-1162
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW225176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife