Provider Demographics
NPI:1720111883
Name:ROWLAND, LESLIE MICHELLE (RN MS,N FNP)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:MICHELLE
Last Name:ROWLAND
Suffix:
Gender:F
Credentials:RN MS,N FNP
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 355
Mailing Address - Street 2:200 NORTH 1ST ST.
Mailing Address - City:CROWELL
Mailing Address - State:TX
Mailing Address - Zip Code:79227-0786
Mailing Address - Country:US
Mailing Address - Phone:940-684-1594
Mailing Address - Fax:
Practice Address - Street 1:200 NORTH 1ST STREET
Practice Address - Street 2:
Practice Address - City:CROWELL
Practice Address - State:TX
Practice Address - Zip Code:79227
Practice Address - Country:US
Practice Address - Phone:940-684-1515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX640262363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142128101OtherTPI NUMBER
TXPO85N2524Medicaid
TXPO85N2524Medicaid
TX142128101OtherTPI NUMBER