Provider Demographics
NPI:1366654105
Name:ROSATI, KRISTINE SUE (QMHP)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:SUE
Last Name:ROSATI
Suffix:
Gender:F
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7220 STONECLIFF DR
Mailing Address - Street 2:APT.1
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-4331
Mailing Address - Country:US
Mailing Address - Phone:919-538-2924
Mailing Address - Fax:919-847-1642
Practice Address - Street 1:923 BROAD ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4141
Practice Address - Country:US
Practice Address - Phone:919-220-4224
Practice Address - Fax:919-220-7390
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator