Provider Demographics
NPI:1922424100
Name:MAGEE, ROSA LINDA
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:LINDA
Last Name:MAGEE
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 1:419 E 12TH AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-6513
Mailing Address - Country:US
Mailing Address - Phone:573-344-4257
Mailing Address - Fax:
Practice Address - Street 1:419 E 12TH AVE APT 6
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-6513
Practice Address - Country:US
Practice Address - Phone:573-344-4257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-11
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKNURP7084164W00000X
TX311178164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No164X00000XNursing Service ProvidersLicensed Vocational Nurse