Individual
NICOLE MARIE ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
152 BLUEFIELD AVE, NEWBURY PARK, CA 91320-4229
(818) 481-8402
Mailing address
152 BLUEFIELD AVE, NEWBURY PARK, CA 91320-4229
(818) 481-8402
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-309472
CA
Other
Enumeration date
01/10/2023
Last updated
01/10/2023
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