Individual
MS. LISA ANN ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
5514 HOHMAN AVE, HAMMOND, IN 46320-1933
(219) 933-2018
(219) 933-2647
Mailing address
5514 HOHMAN AVE, HAMMOND, IN 46320-1933
(219) 933-2018
(219) 933-2647
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041279040
IL
363LF0000X
Family Nurse Practitioner
209008102
IL
363LF0000X
Family Nurse Practitioner
Primary
28142429A
IN
Other
Enumeration date
11/30/2009
Last updated
04/08/2010
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