Individual
MS. KIMBERLY KAY ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
421 BIRDIE DR, APT. #3, MARION, AR 72364-1647
(901) 277-8968
Mailing address
421 BIRDIE DR, APT. #3, MARION, AR 72364-1647
(901) 277-8968
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
147802783
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147802783
—
AR
Enumeration date
05/14/2008
Last updated
05/14/2008
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