Basic Information
| Provider Information | |||||||||
| NPI: | 1073531422 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TESSMANN | ||||||||
| FirstName: | ROWENA | ||||||||
| MiddleName: | |||||||||
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| Credential: | PMH-NP, PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 58 ELM ST. | ||||||||
| Address2: | |||||||||
| City: | WATERVILLE | ||||||||
| State: | ME | ||||||||
| PostalCode: | 04901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2076802065 | ||||||||
| FaxNumber: | 2076802068 | ||||||||
| Practice Location | |||||||||
| Address1: | 58 ELM ST. | ||||||||
| Address2: | |||||||||
| City: | WATERVILLE | ||||||||
| State: | ME | ||||||||
| PostalCode: | 04901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2076802065 | ||||||||
| FaxNumber: | 2076802068 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2006 | ||||||||
| LastUpdateDate: | 07/13/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SP0809X | R038001 | ME | N | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psych/Mental Health, Adult | 363LP0808X | R038001 | ME | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363L00000X | AP 081192 | ME | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 432295299 | 05 | ME | MEDICAID | 238000099 | 05 | ME | MEDICAID |