Individual
JESSICA ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1740 SOUTH ST STE 200, PHILADELPHIA, PA 19146-1514
(215) 735-5600
Mailing address
2400 CHESTNUT ST APT 2709, PHILADELPHIA, PA 19103-4324
(978) 854-2354
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
SP021412
PA
Other
Enumeration date
04/01/2020
Last updated
04/01/2020
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