Provider Demographics
NPI:1376158717
Name:ROOSE, LINDSAY MARIE (APRN, CNM)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:MARIE
Last Name:ROOSE
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:OH
Mailing Address - Zip Code:43506-1690
Mailing Address - Country:US
Mailing Address - Phone:419-636-1131
Mailing Address - Fax:419-636-3100
Practice Address - Street 1:433 W HIGH ST
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:OH
Practice Address - Zip Code:43506-1690
Practice Address - Country:US
Practice Address - Phone:419-633-0755
Practice Address - Fax:419-633-0758
Is Sole Proprietor?:No
Enumeration Date:2020-09-12
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife