Individual
JESSICA ANNE ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
55 KUAU BEACH PL, PAIA, HI 96779-8121
(808) 214-2992
Mailing address
PO BOX 880926, PUKALANI, HI 96788-0926
(808) 866-6512
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
76910
HI
Other
Enumeration date
05/31/2018
Last updated
05/31/2018
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