Individual
ANITA ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
69 MAZE PLZ, ELIZABETH, WV 26143-5127
(304) 275-5001
Mailing address
69 MAZE PLZ, ELIZABETH, WV 26143-5127
(304) 275-5001
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
75123
WV
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
02/14/2022
Last updated
12/20/2022
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