Individual
JEANETTE ELAINE ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1061 HARMON AVE, BLDG 302, FORT STEWART, GA 31314-5641
(912) 435-5265
Mailing address
1061 HARMON AVE, BLDG 302, FORT STEWART, GA 31314-5641
(912) 435-5265
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001202445
VA
Other
Enumeration date
09/04/2014
Last updated
09/04/2014
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