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Individual
ELLEN B ROOSE
Active
Individual
ELLEN B ROOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
26536
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0045666
—
IA
01
—
26536
WELLMARK BCBS
IA
Enumeration date
02/23/2006
Last updated
06/25/2009
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