Provider Demographics
NPI:1497879381
Name:ROWELL, NANCY JO (FNP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:JO
Last Name:ROWELL
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 1:2200 4TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-2856
Mailing Address - Country:US
Mailing Address - Phone:406-454-2381
Mailing Address - Fax:
Practice Address - Street 1:1220 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3764
Practice Address - Country:US
Practice Address - Phone:406-268-1510
Practice Address - Fax:406-268-1914
Is Sole Proprietor?:No
Enumeration Date:2007-03-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN19935363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT4304876Medicaid
MT4304876Medicaid