Provider Demographics
NPI:1841898699
Name:ROWE, KAREN ROSE (CNA QSP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ROSE
Last Name:ROWE
Suffix:
Gender:F
Credentials:CNA QSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:989 5TH AVE W
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-3834
Mailing Address - Country:US
Mailing Address - Phone:701-590-0149
Mailing Address - Fax:
Practice Address - Street 1:989 5TH AVE W
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-3834
Practice Address - Country:US
Practice Address - Phone:701-590-0149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND14567533747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty