| Doctor Name: | MS. ANNA MARIE DEROOSE |
| NPI Number: | 1437121969 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP, CPNP |
| License Number: | R089564 |
| Business Practice Address: | 1792 Merritt Blvd Dundalk, MD - 21222 |
| Business Phone Number: | 4102841133 |
| Business Fax Number: | 4102843371 |
| Mailing Address: | 1792 Merritt Blvd, DUNDALK |
| State: | MD |
| Postal Code: | 21222 |
| Phone Number: | 4102841133 |
| Fax Number: | 4102843371 |
| NPI Enumeration Date: | 02/07/2006 |
| NPI Last Update Date: | 04/20/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | R089564 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |