Provider Demographics
NPI:1144837865
Name:ROWE, AMBER
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:ROWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 ARNOLD AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-1705
Mailing Address - Country:US
Mailing Address - Phone:937-722-7390
Mailing Address - Fax:
Practice Address - Street 1:891 COUNTY ROAD 5
Practice Address - Street 2:
Practice Address - City:ZANESFIELD
Practice Address - State:OH
Practice Address - Zip Code:43360-9744
Practice Address - Country:US
Practice Address - Phone:937-407-5256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-27
Last Update Date:2020-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0189002Medicaid