Provider Demographics
NPI:1568968691
Name:ROSAS, MONIKA MICHELLE (NP)
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:MICHELLE
Last Name:ROSAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17594 10 MILE RD
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-7855
Mailing Address - Country:US
Mailing Address - Phone:269-830-1479
Mailing Address - Fax:
Practice Address - Street 1:17594 10 MILE RD
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-7855
Practice Address - Country:US
Practice Address - Phone:269-830-1479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704270995363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily