Provider Demographics
NPI:1306859525
Name:ROSE, BARBARA ANNE (RN)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANNE
Last Name:ROSE
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 1:4800 WILLIAMSBURG LN
Mailing Address - Street 2:# 213
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-8611
Mailing Address - Country:US
Mailing Address - Phone:858-552-8585
Mailing Address - Fax:858-552-8585
Practice Address - Street 1:3350 LA JOLLA VILLAGE DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92161-0002
Practice Address - Country:US
Practice Address - Phone:858-552-8585
Practice Address - Fax:858-552-8585
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA515104163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator