Provider Demographics
NPI:1265434088
Name:ROWLAND, MELISSA (N P)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:ROWLAND
Suffix:
Gender:F
Credentials:N P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WELLNESS BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-2872
Mailing Address - Country:US
Mailing Address - Phone:803-888-2282
Mailing Address - Fax:803-888-2299
Practice Address - Street 1:1 WELLNESS BLVD STE 106
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-2872
Practice Address - Country:US
Practice Address - Phone:803-888-2282
Practice Address - Fax:803-888-2299
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN1367363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP0698Medicaid
P88281Medicare UPIN