Provider Demographics
NPI:1730829656
Name:ROWLAND, SHELBY MIRANDA
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:MIRANDA
Last Name:ROWLAND
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 1:424 BAYONNE DR
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:OH
Mailing Address - Zip Code:45377-2500
Mailing Address - Country:US
Mailing Address - Phone:937-689-2015
Mailing Address - Fax:
Practice Address - Street 1:708 WYNWOOD CT
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45431-2870
Practice Address - Country:US
Practice Address - Phone:937-797-7685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-30
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker