Provider Demographics
NPI:1528563657
Name:ROSAS, KAREN YAMILI
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:YAMILI
Last Name:ROSAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3258 E PLANTATION DR
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:TX
Mailing Address - Zip Code:77571-7512
Mailing Address - Country:US
Mailing Address - Phone:932-955-4775
Mailing Address - Fax:
Practice Address - Street 1:3258 E PLANTATION DR
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:TX
Practice Address - Zip Code:77571-7512
Practice Address - Country:US
Practice Address - Phone:832-955-4775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX342176164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse