Provider Demographics
NPI:1619087616
Name:ROWAN, REBECCA M (NP)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:M
Last Name:ROWAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1539 HARRINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:SC
Mailing Address - Zip Code:29108-2817
Mailing Address - Country:US
Mailing Address - Phone:803-944-7801
Mailing Address - Fax:
Practice Address - Street 1:1539 HARRINGTON ST
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:SC
Practice Address - Zip Code:29108-2817
Practice Address - Country:US
Practice Address - Phone:803-944-7801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2959363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP5316Medicaid
SCQ71723Medicare UPIN
SCAA15245649Medicare PIN