Doctor Name: | MRS. JENNIFER NORRIS ROSAS |
NPI Number: | 1134348246 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | A.P.N. |
License Number: | |
Business Practice Address: | 15821 S Park Ave South Holland, IL - 604731506 |
Business Phone Number: | 7082250200 |
Business Fax Number: | 7082250202 |
Mailing Address: | 15821 S Park Ave, SOUTH HOLLAND |
State: | IL |
Postal Code: | 604731506 |
Phone Number: | 7082250200 |
Fax Number: | 7082250202 |
NPI Enumeration Date: | 04/25/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |