Provider Demographics
NPI:1043767833
Name:HABEICH, ROSEMARIE (RN)
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:
Last Name:HABEICH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7321 FOXRIDGE CIR UNIT 1
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99518-2710
Mailing Address - Country:US
Mailing Address - Phone:907-360-0258
Mailing Address - Fax:
Practice Address - Street 1:7321 FOXRIDGE CIR UNIT 1
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-2710
Practice Address - Country:US
Practice Address - Phone:907-360-0258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKNURR22208163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse