Provider Demographics
NPI:1053654962
Name:ROSENGRANT, GEORGENE E (RN)
Entity Type:Individual
Prefix:
First Name:GEORGENE
Middle Name:E
Last Name:ROSENGRANT
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:PO BOX 73
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:14423-0073
Mailing Address - Country:US
Mailing Address - Phone:585-538-9825
Mailing Address - Fax:
Practice Address - Street 1:294 GRAND AVE
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:NY
Practice Address - Zip Code:14423-1104
Practice Address - Country:US
Practice Address - Phone:585-538-9825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY448461163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse