Provider Demographics
NPI:1821619446
Name:ROWE, LORETTA LYNN (HEALTHCARE WORKER)
Entity Type:Individual
Prefix:MRS
First Name:LORETTA
Middle Name:LYNN
Last Name:ROWE
Suffix:
Gender:F
Credentials:HEALTHCARE WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 CONCORD AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-2419
Mailing Address - Country:US
Mailing Address - Phone:419-631-7584
Mailing Address - Fax:
Practice Address - Street 1:239 CONCORD AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-2419
Practice Address - Country:US
Practice Address - Phone:419-631-7584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker