Provider Demographics
NPI:1962117325
Name:ROWE, NOVELETTE BERNADETTE
Entity type:Individual
Prefix:
First Name:NOVELETTE
Middle Name:BERNADETTE
Last Name:ROWE
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 1:4375 CHATUGE DR
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-1865
Mailing Address - Country:US
Mailing Address - Phone:404-229-9622
Mailing Address - Fax:
Practice Address - Street 1:4375 CHATUGE DR
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-1865
Practice Address - Country:US
Practice Address - Phone:404-229-9622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN109968163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health