Individual
JENNIFER ANN ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6 MOUNTAIN LEDGE, GANSEVOORT, NY 12831-2588
(518) 584-0335
(518) 583-7665
Mailing address
6 WELLNESS WAY STE 201, LATHAM, NY 12110-2156
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
382401
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03648780
—
NY
Enumeration date
05/09/2013
Last updated
01/13/2026
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