Provider Demographics
NPI:1699390500
Name:ROWELL, DONNA MARIE (RPH)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIE
Last Name:ROWELL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12750 SAINT FRANCIS DR
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-0264
Mailing Address - Country:US
Mailing Address - Phone:219-681-6801
Mailing Address - Fax:
Practice Address - Street 1:12750 SAINT FRANCIS DR
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-0264
Practice Address - Country:US
Practice Address - Phone:219-681-6801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2024-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA0015580183500000X
MI5315145982183500000X
TX73304183500000X
IN26021562A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN26021562AOtherPHARMACIST LICENSE
COPHA0015580OtherPHARMACIST LICENSE
TX73304OtherPHARMACIST LICENSE
MI5315145982OtherPHARMACIST LICENSE