Provider Demographics
NPI:1023349677
Name:ROWE, KIRSTEN (ARNP)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:ROWE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E. DIXIE AVENUE
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748
Mailing Address - Country:US
Mailing Address - Phone:352-323-4267
Mailing Address - Fax:352-323-5039
Practice Address - Street 1:5554 CLARCONA OCOEE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-4056
Practice Address - Country:US
Practice Address - Phone:407-292-0292
Practice Address - Fax:407-292-5175
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3178682363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003825400Medicaid
FLCU990VMedicare PIN
FLCU990WMedicare PIN
FLCU990YMedicare PIN
FL003825400Medicaid