Individual
DR. JENNIFER A ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3616 NETHERLAND INN RD STE 6, KINGSPORT, TN 37660-7296
(423) 403-3258
(423) 295-9626
Mailing address
3616 NETHERLAND INN RD STE 6, KINGSPORT, TN 37660-7296
(423) 403-3258
(423) 295-9626
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
49880
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063730943
—
VA
05
—
Q000752
—
TN
Enumeration date
05/17/2010
Last updated
06/17/2024
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