Provider Demographics
NPI:1265006688
Name:FLUHARTY, ROSE (BS, MSCN)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:FLUHARTY
Suffix:
Gender:F
Credentials:BS, MSCN
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 1398
Mailing Address - Street 2:
Mailing Address - City:MARIPOSA
Mailing Address - State:CA
Mailing Address - Zip Code:95338-1398
Mailing Address - Country:US
Mailing Address - Phone:209-628-6674
Mailing Address - Fax:
Practice Address - Street 1:5067 HWY 140
Practice Address - Street 2:SUITE C
Practice Address - City:MARIPOSA
Practice Address - State:CA
Practice Address - Zip Code:95338-9448
Practice Address - Country:US
Practice Address - Phone:209-628-6674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-19
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist