Organization
ROSE FAMILY HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN M WAGNER FNP-C (OWNER)
(850) 806-2440
Entity
Organization
Contact information
Practice address
4400 E HIGHWAY 20 STE 207, NICEVILLE, FL 32578-7700
(850) 806-2440
Mailing address
4400 E HIGHWAY 20 STE 207, NICEVILLE, FL 32578-7700
(850) 806-2440
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/10/2024
Last updated
08/03/2025
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