Provider Demographics
NPI:1013750231
Name:ROWANS, KYLIE D (LPN)
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:D
Last Name:ROWANS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19832 32ND AVE SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-7222
Mailing Address - Country:US
Mailing Address - Phone:425-215-3504
Mailing Address - Fax:
Practice Address - Street 1:19832 32ND AVE SE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012-7222
Practice Address - Country:US
Practice Address - Phone:425-215-3504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-15
Last Update Date:2024-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP61183661164W00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No164W00000XNursing Service ProvidersLicensed Practical Nurse