Provider Demographics
NPI:1275766586
Name:ROWE, JADE LEAH (LPN)
Entity type:Individual
Prefix:MRS
First Name:JADE
Middle Name:LEAH
Last Name:ROWE
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 1:132 WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:ATHOL
Mailing Address - State:MA
Mailing Address - Zip Code:01331-1214
Mailing Address - Country:US
Mailing Address - Phone:978-855-6060
Mailing Address - Fax:
Practice Address - Street 1:132 WILSON AVE
Practice Address - Street 2:
Practice Address - City:ATHOL
Practice Address - State:MA
Practice Address - Zip Code:01331-1214
Practice Address - Country:US
Practice Address - Phone:978-855-6060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA68293164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse