Provider Demographics
NPI:1376217315
Name:BLACKSTONE, ROSA MARIA (DNP)
Entity Type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:MARIA
Last Name:BLACKSTONE
Suffix:
Gender:F
Credentials:DNP
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Mailing Address - Street 1:4003 CREEKSIDE LOOP
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-3962
Mailing Address - Country:US
Mailing Address - Phone:509-248-6616
Mailing Address - Fax:509-225-2708
Practice Address - Street 1:1300 N. FIRST STREET
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-9890
Practice Address - Country:US
Practice Address - Phone:509-853-4327
Practice Address - Fax:509-853-1007
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-03
Last Update Date:2023-02-10
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Provider Licenses
StateLicense IDTaxonomies
WAAP61202162363LC1500X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health