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Individual

COLLEEN ROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
400 N PEPPER AVE, DEPT. GENERAL SURGERY MOD#3, COLTON, CA 92324-1801
(909) 580-6210
(909) 580-1363
Mailing address
PO BOX 670, REDLANDS, CA 92373-0221
(909) 580-6210
(909) 580-1363

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN 577240
CA
363L00000X
Nurse Practitioner
Primary
NP 18595
CA

Other

Enumeration date
06/16/2008
Last updated
11/05/2008
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