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Individual

MARIROSE FOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1840 F ST, GENEVA, NE 68361-2211
(402) 759-4485
(402) 759-4487
Mailing address
PO BOX 268, GENEVA, NE 68361-0268
(402) 759-4485
(402) 759-4487

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
414
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
207Q00000X
NE
Enumeration date
07/26/2006
Last updated
03/13/2012
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