Doctor Name: | ROSE A MEDICE |
NPI Number: | 1144272337 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | SP007969 |
Business Practice Address: | 4131 Oregon Pike Brownstown, PA - 175085083 |
Business Phone Number: | 7178591123 |
Business Fax Number: | 7178592898 |
Mailing Address: | 4131 Oregon Pike, Suite C EPHRATA |
State: | PA |
Postal Code: | 175229550 |
Phone Number: | 7178595161 |
Fax Number: | 7178595169 |
NPI Enumeration Date: | 05/16/2006 |
NPI Last Update Date: | 05/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | SP007969 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |