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Individual

MARISSA LEE ROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
1982 W MAIN ST STE 101, MESA, AZ 85201-6917
(480) 677-8282
(844) 470-2777
Mailing address
261 N ROOSEVELT AVE, CHANDLER, AZ 85226-2617
(480) 677-8282
(844) 470-2777

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AP11499
AZ
363LF0000X
Family Nurse Practitioner
1227510
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AP11499
AZ STATE BOARD OF NURSING
AZ
Enumeration date
07/10/2018
Last updated
02/27/2026
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