Provider Demographics
NPI:1538503677
Name:PANGANIBAN, ROWENA D (NP-C)
Entity Type:Individual
Prefix:
First Name:ROWENA
Middle Name:D
Last Name:PANGANIBAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ROWENA
Other - Middle Name:
Other - Last Name:CALLANTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:2370 CORPORATE CIR STE 300
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7760
Mailing Address - Country:US
Mailing Address - Phone:702-910-3950
Mailing Address - Fax:702-786-6650
Practice Address - Street 1:100 N GREEN VALLEY PKWY STE 239
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7704
Practice Address - Country:US
Practice Address - Phone:702-844-4841
Practice Address - Fax:702-844-4484
Is Sole Proprietor?:No
Enumeration Date:2013-04-19
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN001457363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily