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Individual
SCOT ROSE
Active
Individual
SCOT ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704267357
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704267357
MI
Other
Enumeration date
03/05/2024
Last updated
08/22/2024
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