Individual
KIMBERLY JEAN ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
923 E CENTRAL AVE, LA FOLLETTE, TN 37766-2768
(423) 907-1404
(423) 907-1160
Mailing address
1431 CENTERPOINT BLVD, SUITE 100, KNOXVILLE, TN 37932-1984
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1795
TN
Other
Enumeration date
05/24/2010
Last updated
02/07/2011
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