Individual
REBEKAH ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
611 LAKESHORE DR, LAKESIDE, IA 50588-7667
(712) 269-0232
Mailing address
611 LAKESHORE DR, LAKESIDE, IA 50588-7667
(712) 269-0232
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A182896
IA
Other
Enumeration date
01/22/2025
Last updated
01/25/2025
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