Provider Demographics
NPI:1174954812
Name:ROWLETT, ARDANA KATE (LPN)
Entity type:Individual
Prefix:
First Name:ARDANA
Middle Name:KATE
Last Name:ROWLETT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:WILLARD
Mailing Address - State:OH
Mailing Address - Zip Code:44890-1175
Mailing Address - Country:US
Mailing Address - Phone:567-224-4194
Mailing Address - Fax:419-951-6120
Practice Address - Street 1:421 SPRING ST
Practice Address - Street 2:
Practice Address - City:WILLARD
Practice Address - State:OH
Practice Address - Zip Code:44890-1175
Practice Address - Country:US
Practice Address - Phone:567-224-4194
Practice Address - Fax:419-951-6120
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-05
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.144750-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse