Provider Demographics
NPI:1083686760
Name:DOBLE, ROSEMARY K (CPNP)
Entity Type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:K
Last Name:DOBLE
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 LYNNFIELD ST
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-4815
Mailing Address - Country:US
Mailing Address - Phone:978-278-5173
Mailing Address - Fax:
Practice Address - Street 1:253 SUMMER ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02210-1114
Practice Address - Country:US
Practice Address - Phone:617-620-1513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA143175363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics