Doctor Name: | MISS MEGAN ANN ROSE |
NPI Number: | 1235399635 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 1135 |
Business Practice Address: | 2351 Connecticut Ave S Suite 200 Sartell, MN - 563772477 |
Business Phone Number: | 3202591411 |
Business Fax Number: | 3202598967 |
Mailing Address: | 2351 Connecticut Ave S, Suite 200 SARTELL |
State: | MN |
Postal Code: | 563772477 |
Phone Number: | 3202591411 |
Fax Number: | 3202598967 |
NPI Enumeration Date: | 06/10/2008 |
NPI Last Update Date: | 02/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 1135 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |