Individual
OLIVIA DENISE ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 15TH ST NW, SUITE A, NORTON, VA 24273-1616
(276) 439-1840
(276) 439-1845
Mailing address
100 15TH ST NW, SUITE A, NORTON, VA 24273-1616
(276) 439-1840
(276) 439-1845
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110004954
VA
363A00000X
Physician Assistant
1642
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457639072
—
VA
Enumeration date
07/31/2011
Last updated
02/23/2017
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