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Individual

CONSTANCE ANN ROSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNP ADULT/GERIATRIC

Contact information

Practice address
115 E MELROSE AVE, BALTIMORE, MD 21212-2945
(410) 435-9073
Mailing address
1042 PIPISTRELLE CT, ODENTON, MD 21113-3842
(410) 688-5390

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R173510
MD
363LG0600X
Gerontology Nurse Practitioner
R173510
MD

Other

Enumeration date
05/08/2011
Last updated
05/08/2011
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