Individual
MR. KYLE D ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
8901 INDIAN HILLS DR STE 200, OMAHA, NE 68114-4032
(402) 397-7057
Mailing address
8901 INDIAN HILLS DR STE 200, OMAHA, NE 68114-4032
(402) 397-7057
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
1650
NE
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073811352
—
NE
Enumeration date
03/10/2011
Last updated
07/21/2022
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