Individual
CARRI ROSE PROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
250 N ROBERTSON BLVD STE 106A, BEVERLY HILLS, CA 90211-1767
(818) 922-2244
Mailing address
9663 SANTA MONICA BLVD # 1151, BEVERLY HILLS, CA 90210-4303
(818) 922-2244
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
196026-30
WI
163WG0000X
General Practice Registered Nurse
849992
CA
363L00000X
Nurse Practitioner
Primary
95009386
CA
Other
Enumeration date
04/12/2018
Last updated
03/26/2020
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