Individual
ANDREW N ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
1925 WHIPPLE AVE # 30, LOGANDALE, NV 89021
(702) 398-3621
(023) 983-6267
Mailing address
1925 WHIPPLE AVE # 30, LOGANDALE, NV 89021-9934
(702) 398-3621
(702) 398-3626
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1560
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000426927
BLUE CROSS
KS
05
—
200359270A
—
KS
Enumeration date
03/17/2006
Last updated
08/03/2018
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