Individual
NANCY L JOHNSON-ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
7481 HIGHWAY 65 69, DES MOINES, IA 50320-9613
(515) 953-1500
(515) 953-2136
Mailing address
7481 HIGHWAY 65 69, DES MOINES, IA 50320-9613
(515) 953-1500
(515) 953-2136
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02899
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0634493
—
IA
05
—
0634550
—
IA
05
—
1700859261
—
IA
01
—
P00445298
RAILROAD MEDICARE
—
Enumeration date
02/07/2006
Last updated
08/14/2012
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