Provider Demographics
NPI:1598308553
Name:GALEN, ROSE ANN (RN)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:ANN
Last Name:GALEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3740 E KESWICK DAM RD
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-1209
Mailing Address - Country:US
Mailing Address - Phone:530-575-0294
Mailing Address - Fax:
Practice Address - Street 1:3740 E KESWICK DAM RD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-1209
Practice Address - Country:US
Practice Address - Phone:530-575-0294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA731672163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse