Provider Demographics
NPI:1366960965
Name:ROWEN, JULIA
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:ROWEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 W MARKHAM ST # 541-10
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7199
Mailing Address - Country:US
Mailing Address - Phone:501-320-7266
Mailing Address - Fax:
Practice Address - Street 1:1801 LOUISVILLE AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201
Practice Address - Country:US
Practice Address - Phone:318-369-5880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-03
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA022139183500000X
ARPD14319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist