| Doctor Name: | MRS. ROSE M ROSS |
| NPI Number: | 1225069412 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 4704091848 |
| Business Practice Address: | 1910 E Miller Rd Fairview, MI - 486218731 |
| Business Phone Number: | 9898485484 |
| Business Fax Number: | 9898487139 |
| Mailing Address: | 1910 E Miller Rd, Po Box 460 FAIRVIEW |
| State: | MI |
| Postal Code: | 486218731 |
| Phone Number: | 9898485484 |
| Fax Number: | 9898487139 |
| NPI Enumeration Date: | 07/05/2006 |
| NPI Last Update Date: | 02/05/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 4704091848 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |