Provider Demographics
NPI:1760173462
Name:GARNETT, ROSE ANN MARIE
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:ANN MARIE
Last Name:GARNETT
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 1:455 E 42ND ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07504-1211
Mailing Address - Country:US
Mailing Address - Phone:973-873-4528
Mailing Address - Fax:
Practice Address - Street 1:20 ARNOT ST
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:NJ
Practice Address - Zip Code:07644-1614
Practice Address - Country:US
Practice Address - Phone:973-470-9494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP05382700164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse