Individual
KYLE PENDLETON ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
420 WILKINSON DR, DYERSBURG, TN 38024-2085
(224) 406-4918
Mailing address
1532 CRAIG RD, DYERSBURG, TN 38024-6750
(224) 406-4918
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN0000034479
TN
Other
Enumeration date
08/29/2023
Last updated
08/29/2023
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