1457026387 NPI number — MRS. HEATHER PICKRAL ROWLAND LPTA

Table of content: MRS. HEATHER PICKRAL ROWLAND LPTA (NPI 1457026387)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457026387 NPI number — MRS. HEATHER PICKRAL ROWLAND LPTA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROWLAND
Provider First Name:
HEATHER
Provider Middle Name:
PICKRAL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPTA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457026387
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4395 DEER VIEW RD.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRETNA
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24557
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-203-2314
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
GRETNA HEALTH AND REHABILITATION
Provider Second Line Business Practice Location Address:
595 VADEN DR,
Provider Business Practice Location Address City Name:
GRETNA
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24557
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-656-1206
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/12/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225200000X , with the licence number:  2306601411 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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