Provider Demographics
NPI:1144549304
Name:NOLASCO, ROWENA DELEON (FNP)
Entity type:Individual
Prefix:MRS
First Name:ROWENA
Middle Name:DELEON
Last Name:NOLASCO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3611 LAKE TERRACE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758
Mailing Address - Country:US
Mailing Address - Phone:916-226-6226
Mailing Address - Fax:818-843-5224
Practice Address - Street 1:577 LAS PALMAS AVE.
Practice Address - Street 2:HEALTH FOR ALL
Practice Address - City:SACREMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815
Practice Address - Country:US
Practice Address - Phone:916-924-6703
Practice Address - Fax:916-263-6981
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18611363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA18611OtherNP
CA624892OtherRN