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Individual

MRS. ROSE M ROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1910 E MILLER RD, FAIRVIEW, MI 48621-8731
(989) 848-5484
(989) 848-7139
Mailing address
1910 E MILLER RD, PO BOX 460, FAIRVIEW, MI 48621-8731
(989) 848-5484
(989) 848-7139

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704091848
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4747166
MI
05
4747175
MI
01
5008773530
BCBS
MI
01
700G210140
BC GROUP PIN
MI
Enumeration date
07/05/2006
Last updated
03/07/2023
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