Provider Demographics
NPI:1083056253
Name:ROSE, ALANA M (FNPC)
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:M
Last Name:ROSE
Suffix:
Gender:F
Credentials:FNPC
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 1599
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04402-1599
Mailing Address - Country:US
Mailing Address - Phone:207-992-9200
Mailing Address - Fax:
Practice Address - Street 1:116 NORTHPORT AVE STE 112
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6096
Practice Address - Country:US
Practice Address - Phone:207-505-4163
Practice Address - Fax:207-338-6458
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP131082363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEE400100710Medicare PIN