Provider Demographics
NPI:1003989872
Name:ROSEN, JANE C (PA-C)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:C
Last Name:ROSEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4700 COYLE RD APT 105
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5089
Mailing Address - Country:US
Mailing Address - Phone:410-456-7622
Mailing Address - Fax:
Practice Address - Street 1:4 W ROLLING CROSSROADS STE 100
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-6280
Practice Address - Country:US
Practice Address - Phone:410-869-0100
Practice Address - Fax:410-869-0460
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDC0000595363A00000X
MDC0-000595207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant