Provider Demographics
NPI:1578194015
Name:ROWLAND, JACOB D (DNP, APN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:D
Last Name:ROWLAND
Suffix:
Gender:M
Credentials:DNP, APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407A YARMOUTH LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-6254
Mailing Address - Country:US
Mailing Address - Phone:609-668-7792
Mailing Address - Fax:
Practice Address - Street 1:2222 NJ-33
Practice Address - Street 2:SUITE H
Practice Address - City:HAMILTON TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08690
Practice Address - Country:US
Practice Address - Phone:609-890-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-03
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR19380500163WC0200X
NJ26NJ01063600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1578194015Medicaid