Individual
ROSETTE WAKANABO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3214 MAIN CAMPUS DR, LEXINGTON, MA 02421-8627
(508) 371-8503
Mailing address
3214 MAIN CAMPUS DR, LEXINGTON, MA 02421-8627
(508) 371-8503
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2320331
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2320331
MA
Other
Enumeration date
11/28/2022
Last updated
02/24/2025
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