Provider Demographics
NPI:1780749622
Name:ROWLAND, SHIRLEY (CNP)
Entity type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:
Last Name:ROWLAND
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9501 LUCY CORR CIR
Mailing Address - Street 2:P. O. BOX 100
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-6697
Mailing Address - Country:US
Mailing Address - Phone:804-751-4385
Mailing Address - Fax:804-751-4497
Practice Address - Street 1:9501 LUCY CORR CIR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6697
Practice Address - Country:US
Practice Address - Phone:804-751-4385
Practice Address - Fax:804-751-4497
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001126558163WG0000X
VA0024126558363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Not Answered363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAS99279Medicare UPIN