Provider Demographics
NPI:1972810794
Name:HEWSON-HUSSEY, ROSE ELIZABETH (ARNP)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:ELIZABETH
Last Name:HEWSON-HUSSEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:ISLAMORADA
Mailing Address - State:FL
Mailing Address - Zip Code:33036-3121
Mailing Address - Country:US
Mailing Address - Phone:305-741-7721
Mailing Address - Fax:
Practice Address - Street 1:85960 OVERSEAS HWY STE 4
Practice Address - Street 2:
Practice Address - City:ISLAMORADA
Practice Address - State:FL
Practice Address - Zip Code:33036-3301
Practice Address - Country:US
Practice Address - Phone:305-741-7721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3228152363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY05JUOtherFL BLUE
FLDS923ZOtherMEDICARE
FLY05JUOtherBCBS