Provider Demographics
NPI:1700827755
Name:ROWSER, MAYOLA (PHD)
Entity type:Individual
Prefix:
First Name:MAYOLA
Middle Name:
Last Name:ROWSER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:415 MULBERRY STREET
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47113-1230
Mailing Address - Country:US
Mailing Address - Phone:812-423-7791
Mailing Address - Fax:812-422-7558
Practice Address - Street 1:5669 DELMAR BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63112-2615
Practice Address - Country:US
Practice Address - Phone:314-531-1770
Practice Address - Fax:314-241-1185
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2025006273363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2025006273OtherPMHNP
IN200530560Medicaid
KY78015823Medicaid
IN000000379234OtherANTHEM PIN
IN200530560Medicaid
KY78015823Medicaid