Provider Demographics
NPI:1780782292
Name:ROWE, RACQUEL RUTH (NP)
Entity type:Individual
Prefix:MRS
First Name:RACQUEL
Middle Name:RUTH
Last Name:ROWE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:RACQUEL
Other - Middle Name:RUTH
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1619
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:3300 MAIN ST
Practice Address - Street 2:2ND FLOOR SUITE A
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01199-1002
Practice Address - Country:US
Practice Address - Phone:413-794-7246
Practice Address - Fax:413-794-7131
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA271733363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health