Provider Demographics
NPI:1770181687
Name:WALSH, ROSEMARIE KATHRYN (CNA)
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:KATHRYN
Last Name:WALSH
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 SHILOH RD
Mailing Address - Street 2:
Mailing Address - City:POINTS
Mailing Address - State:WV
Mailing Address - Zip Code:25437-9612
Mailing Address - Country:US
Mailing Address - Phone:304-492-5183
Mailing Address - Fax:
Practice Address - Street 1:179 SHILOH RD
Practice Address - Street 2:
Practice Address - City:POINTS
Practice Address - State:WV
Practice Address - Zip Code:25437-9612
Practice Address - Country:US
Practice Address - Phone:304-492-5183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV392913747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant