Basic Information
| Provider Information | |||||||||
| NPI: | 1376665075 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROWEN | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | SUE | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3133 E CAMELBACK RD | ||||||||
| Address2: | STE 105 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850164545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6025221900 | ||||||||
| FaxNumber: | 6023813281 | ||||||||
| Practice Location | |||||||||
| Address1: | 2200 N 3RD ST | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850041401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022586634 | ||||||||
| FaxNumber: | 6022584311 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2007 | ||||||||
| LastUpdateDate: | 01/02/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 3600 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.