Individual
ROSE M ROTH-BOWERSOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP-BC
Contact information
Practice address
451 HEALTH PKWY, SUITE E, PAW PAW, MI 49079-8242
(269) 655-3090
(269) 655-0763
Mailing address
451 HEALTH PKWY, SUITE E, PAW PAW, MI 49079-8242
(269) 655-3090
(269) 655-0763
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
470420936
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235131137
BCBSM - BLH
MI
05
—
1417937020
—
MI
05
—
4469434
—
MI
Enumeration date
01/19/2006
Last updated
10/15/2014
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