Provider Demographics
NPI:1144554205
Name:ROWE, LETRICA (PA-C)
Entity type:Individual
Prefix:
First Name:LETRICA
Middle Name:
Last Name:ROWE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2503 S AVENUE A STE 1
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7174
Mailing Address - Country:US
Mailing Address - Phone:928-344-3350
Mailing Address - Fax:928-344-2270
Practice Address - Street 1:2503 S AVENUE A STE 1
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7174
Practice Address - Country:US
Practice Address - Phone:928-344-3350
Practice Address - Fax:928-344-2270
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4460363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant