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Individual

JENNICA LISETTE ROSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
5046 N HIGHLAND ST, RUSTON, WA 98407-3118
(210) 906-9658
Mailing address
1210 TACOMA AVE S APT 303, TACOMA, WA 98402-2020
(210) 906-9658

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP140646
TX
363LF0000X
Family Nurse Practitioner
Primary
AP61341503
WA

Other

Enumeration date
02/16/2019
Last updated
09/09/2024
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