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Individual

DR. REBECCA JUDENE ROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1 JACK FOSTER DR, SHENANDOAH, IA 51601-4586
(712) 246-7485
(712) 246-7036
Mailing address
1 JACK FOSTER DR, SHENANDOAH, IA 51601-4586
(712) 246-7485
(712) 246-7036

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
248293-1
NY
208600000X
Surgery Physician
Primary
38581
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00606
IA
05
10025458000
NE
01
260558
MIDLANDS
05
7728720
SD
01
P00805363
RR MEDICARE
IA
Enumeration date
02/17/2009
Last updated
10/13/2021
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