Provider Demographics
NPI:1932146313
Name:ROWLAND, AUDREY (NP)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:ROWLAND
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:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1237 HARDING PL
Practice Address - Street 2:STE 3100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204
Practice Address - Country:US
Practice Address - Phone:704-373-0212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19354363L00000X
NC960062363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1932146313Medicaid
NCP00612331OtherRAILROAD MEDICARE
NC84635OtherBCBS
NC8984635Medicaid
SCNP1147Medicaid
NCQ41640Medicare UPIN
NC2592269BMedicare PIN
NC8984635Medicaid
NC2592269Medicare PIN
NCP00612331OtherRAILROAD MEDICARE