Individual
BRANDI N ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
101 MAIN ST, FULTON, KY 42041-1601
(270) 472-5245
(270) 472-5249
Mailing address
101 MAIN ST, FULTON, KY 42041-1601
(270) 472-5245
(270) 472-5249
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
19671
TN
363LF0000X
Family Nurse Practitioner
Primary
4015211
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
158274
RN LICENSE
TN
01
—
19671
NP LICENSE - TN
TN
01
—
4015211
NP LICENSE KY
KY
05
—
7100965780
—
KY
05
—
Q012535
—
TN
Enumeration date
02/13/2015
Last updated
08/06/2024
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