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Individual

NOREEN ELLEN ROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1136 WESTOWNE DR, NEENAH, WI 54956
(920) 456-2023
(920) 456-2025
Mailing address
1136 WESTOWNE DR, NEENAH, WI 54956-2175
(920) 456-2023
(920) 456-2025

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1277-33
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1277-033
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1457371890
WI
Enumeration date
07/20/2006
Last updated
12/03/2021
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