Basic Information
Provider Information
NPI: 1881604643
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROWE
FirstName: CHARLOTTE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: R. N., N. P.
OtherOrganizationName:  
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OtherLastName:  
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OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 40 S MAIN ST STE 1300
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381035513
CountryCode: US
TelephoneNumber: 8669490108
FaxNumber:  
Practice Location
Address1: 525 N TRYON ST STE 1600
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282020213
CountryCode: US
TelephoneNumber: 8669490108
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/08/2006
LastUpdateDate: 09/10/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/31/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X5004429NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363L00000X304280NYN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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