Individual
SCOT ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
3409 LUDINGTON ST, ESCANABA, MI 49829-4212
(906) 786-8343
(906) 786-4430
Mailing address
PO BOX 180, HARRIS, MI 49845-0180
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704267357
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704267357
MI
Other
Enumeration date
03/05/2024
Last updated
08/22/2024
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