Individual
DAVID ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4213 WALNEY RD, CHANTILLY, VA 20151-2923
(703) 205-9452
Mailing address
4213 WALNEY RD, CHANTILLY, VA 20151-2923
(703) 205-9452
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
0001234181
VA
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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