| Doctor Name: | DR. NICHOLE A ROSA |
| NPI Number: | 1194804815 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | 334797 |
| Business Practice Address: | 433 Church St New Milford, PA - 188346603 |
| Business Phone Number: | 5704654500 |
| Business Fax Number: | 5704654501 |
| Mailing Address: | 433 Church St, P.o. Box 602 NEW MILFORD |
| State: | PA |
| Postal Code: | 188346603 |
| Phone Number: | 5704654500 |
| Fax Number: | 5704654501 |
| NPI Enumeration Date: | 11/03/2006 |
| NPI Last Update Date: | 01/07/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 334797 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |