# GINA L ROSE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1699716688
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD072494L | PA | Yes |

## Other

- **Enumeration date:** 06/09/2006
- **Last updated:** 06/05/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0018651570003 | — | PA |
| 01 | — | 10935099 | CAQH ID\# | PA |
| 01 | — | 1150744 | KEYSTONE MERCY | PA |
| 01 | — | 1313836 | HIGHMARK BLUE SHIELD | PA |
| 01 | — | 2007117000 | AMERIHEALTH/INTERCOUNTY | PA |
| 01 | — | 2635215 | AETNA HMO | PA |
| 01 | — | 7008842 | CIGNA HMO/PPO | PA |
| 01 | — | 7696259 | AETNA PPO | PA |
| 01 | — | 9201950 | PHCS | PA |
| 01 | — | P00260461 | RRM | PA |