Individual
SYDNEY MICHELLE ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5016 US HWY 75, DENISON, TX 75020-4584
(903) 416-2070
Mailing address
816 W CANNON ST, FORT WORTH, TX 76104-3194
(817) 321-0404
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1057022
TX
363LA2100X
Acute Care Nurse Practitioner
1057022
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1057022
TEXAS BOARD OF NURSING
TX
Enumeration date
07/21/2021
Last updated
02/22/2022
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