Individual
MRS. ANITA LYNN ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
410 GLENN AVE, SUITE 200, BLOOMSBURG, PA 17815-1200
(570) 784-1723
(570) 784-8512
Mailing address
410 GLENN AVE, SUITE 200, BLOOMSBURG, PA 17815-1200
(570) 784-1723
(570) 784-8512
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN503929L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100746682006
—
PA
05
—
1022487130001
—
PA
01
—
1255488904
NPI NUMBER FOR FACILITY
PA
Enumeration date
02/13/2009
Last updated
02/13/2009
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