| Doctor Name: | ROSA GENEVICH |
| NPI Number: | 1356591663 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 715939 |
| Business Practice Address: | Building 170 Fort Irwin, CA - 92310 |
| Business Phone Number: | 7603805031 |
| Business Fax Number: | |
| Mailing Address: | Building 170, FORT IRWIN |
| State: | CA |
| Postal Code: | 92310 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/23/2008 |
| NPI Last Update Date: | 09/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC0400X |
| License Number: | 715939 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Case Management |
| Taxonomy Definition: | |