Provider Demographics
NPI:1033407788
Name:VANCE, ROSE MARIE (LICENSED MIDWIFE)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:MARIE
Last Name:VANCE
Suffix:
Gender:F
Credentials:LICENSED MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 BUTTERNUT DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-6727
Mailing Address - Country:US
Mailing Address - Phone:972-814-8143
Mailing Address - Fax:
Practice Address - Street 1:408 BUTTERNUT DR
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-6727
Practice Address - Country:US
Practice Address - Phone:972-814-8143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96093176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife