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Individual

MISS JENNIFER K ROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCHIS

Contact information

Practice address
600 HARMON LOOP RD, SUITE 106, DEDEDO, GU 96929-6536
(671) 637-4327
(671) 637-7018
Mailing address
600 HARMON LOOP RD, SUITE 106, DEDEDO, GU 96929-6536
(671) 637-4327
(671) 637-7018

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
30-201100718-001
GU
237700000X
Hearing Instrument Specialist
HA 60221924
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
164
GU
01
2R027
MEDICAID SAIPAN
Enumeration date
10/05/2006
Last updated
01/03/2013
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