Provider Demographics
NPI:1194499723
Name:ROWE, NICOLA ANN-SIMONE (NP)
Entity type:Individual
Prefix:
First Name:NICOLA
Middle Name:ANN-SIMONE
Last Name:ROWE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 E 35TH ST APT 7B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4213
Mailing Address - Country:US
Mailing Address - Phone:347-939-7551
Mailing Address - Fax:
Practice Address - Street 1:1145 E 35TH ST APT 7B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-4213
Practice Address - Country:US
Practice Address - Phone:347-939-7551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY403283163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent