Provider Demographics
NPI:1871978031
Name:ROWLAND, WENDY
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:
Last Name:ROWLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:ROWLAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA
Mailing Address - Street 1:440 NEW BRITAIN AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06062-2036
Mailing Address - Country:US
Mailing Address - Phone:860-747-9441
Mailing Address - Fax:860-747-8597
Practice Address - Street 1:440 NEW BRITAIN AVE
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:CT
Practice Address - Zip Code:06062-2036
Practice Address - Country:US
Practice Address - Phone:860-747-9441
Practice Address - Fax:860-747-8597
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000378363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant