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Individual

ROSE MARIE MCINTOSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNPC CS

Contact information

Practice address
821 N NELLIS BLVD STE 100, LAS VEGAS, NV 89110-5387
(702) 438-4003
(702) 438-0555
Mailing address
PO BOX 98978, LAS VEGAS, NV 89193-8978
(702) 216-3346
(702) 671-6883

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024114970
VA
363L00000X
Nurse Practitioner
13826
CA
363LF0000X
Family Nurse Practitioner
Primary
819101
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1063470417
NV
01
8919101
STATE LICENSE
NV
01
ZZZ31887Z
CORPORATE PTAN NUMBER
CA
Enumeration date
05/03/2006
Last updated
05/16/2019
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