Individual
NANCY C ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
400 C ST, SALT LAKE CITY, UT 84143-1005
(801) 408-3446
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 408-3446
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
53311101205
UT
207V00000X
Obstetrics & Gynecology Physician
5331110-1205
UT
207VM0101X
Maternal & Fetal Medicine Physician
Primary
5331110-1205
UT
Other
Enumeration date
07/20/2006
Last updated
03/18/2008
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