Individual
ROSE LISI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2870
(203) 384-3000
Mailing address
267 GRANT ST, BRIDGEPORT, CT 06610-2870
Taxonomy
Speciality
Code
Description
License number
State
163WX0003X
Inpatient Obstetric Registered Nurse
Primary
171619
CT
Other
Enumeration date
09/18/2024
Last updated
09/18/2024
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