Individual
CAROLYN S ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
711 GENN DR, WAMEGO, KS 66547-1179
(785) 456-2295
(785) 456-9467
Mailing address
711 GENN DR, WAMEGO, KS 66547-1179
(785) 456-2295
(785) 456-9467
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
13-26942-082
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13-26942-082
REGISTERED NURSE
KS
01
—
144577
BLUE CROSS PROVIDER #
KS
01
—
54153
REG. NURSE ANESTHETIST
KS
Enumeration date
07/03/2006
Last updated
07/08/2007
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