Individual
MRS. HEATHER TIFFANY ROSA I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
511 PIERCE ST, KINGSTON, PA 18704-5731
(570) 714-3333
(570) 338-3993
Mailing address
511 PIERCE ST, KINGSTON, PA 18704-5731
(570) 714-3333
(570) 338-3993
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP020032
PA
Other
Enumeration date
05/02/2019
Last updated
08/31/2020
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