Individual
CHEROKEE ROSE LEE ROVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11206
MN
363A00000X
Physician Assistant
AMD-1104
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578863924
—
MN
05
—
1578863924
—
MT
Enumeration date
11/01/2010
Last updated
01/11/2022
Update your record
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