Provider Demographics
NPI:1922455997
Name:ARCHEMETRE, ROSE (MD)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:ARCHEMETRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 NATURE TRL STE 3
Mailing Address - Street 2:
Mailing Address - City:RADCLIFF
Mailing Address - State:KY
Mailing Address - Zip Code:40160-9111
Mailing Address - Country:US
Mailing Address - Phone:270-351-2323
Mailing Address - Fax:270-351-8031
Practice Address - Street 1:75 NATURE TRL STE 3
Practice Address - Street 2:
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160-9111
Practice Address - Country:US
Practice Address - Phone:270-351-2323
Practice Address - Fax:270-351-8031
Is Sole Proprietor?:No
Enumeration Date:2016-05-19
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP337207R00000X, 208000000X
MI4301109579390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics