Provider Demographics
NPI:1962407981
Name:ROWSEMITT, CAROL N (PHD, RN, FNP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:N
Last Name:ROWSEMITT
Suffix:
Gender:F
Credentials:PHD, RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 QUAIL DR
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-6341
Mailing Address - Country:US
Mailing Address - Phone:805-782-9704
Mailing Address - Fax:805-773-3120
Practice Address - Street 1:855 4TH ST
Practice Address - Street 2:# 2
Practice Address - City:PISMO BEACH
Practice Address - State:CA
Practice Address - Zip Code:93449-3102
Practice Address - Country:US
Practice Address - Phone:805-773-3130
Practice Address - Fax:805-773-3120
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA556135363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWNP12007CMedicare ID - Type Unspecified
P21223Medicare UPIN