Provider Demographics
NPI: | 1386840890 |
---|---|
Name: | ROSE-JONES, LISA JEANNETTE (MD) |
Entity Type: | Individual |
Prefix: | DR |
First Name: | LISA |
Middle Name: | JEANNETTE |
Last Name: | ROSE-JONES |
Suffix: | |
Gender: | F |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 101 MANNING DR |
Mailing Address - Street 2: | CB #7075 |
Mailing Address - City: | CHAPEL HILL |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27514-4220 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 919-966-5205 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 101 MANNING DR |
Practice Address - Street 2: | CB # 7075 |
Practice Address - City: | CHAPEL HILL |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27514-4220 |
Practice Address - Country: | US |
Practice Address - Phone: | 919-966-5205 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2007-06-22 |
Last Update Date: | 2017-05-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NC | 2010-01147 | 207R00000X, 207RA0001X, 207RC0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207RA0001X | Allopathic & Osteopathic Physicians | Internal Medicine | Advanced Heart Failure and Transplant Cardiology |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |