Individual
ROSE N KIKOYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
36 LIONEL AVE APT A, WALTHAM, MA 02452-4820
(857) 334-8700
Mailing address
36 LIONEL AVE APT A, WALTHAM, MA 02452-4820
(857) 334-8700
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN88813
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05
—
—
Enumeration date
10/21/2018
Last updated
08/12/2022
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