Provider Demographics
NPI:1689167546
Name:HERSEY, ROSEMARY ANN (BSN, RN, MAC, LAC)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:ANN
Last Name:HERSEY
Suffix:
Gender:F
Credentials:BSN, RN, MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 CHARLES ST STE 102
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-3521
Mailing Address - Country:US
Mailing Address - Phone:240-380-0884
Mailing Address - Fax:
Practice Address - Street 1:303 CHARLES ST STE 102
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-3521
Practice Address - Country:US
Practice Address - Phone:240-380-0884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02445171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U02445OtherACUPUNCTURIST