Provider Demographics
NPI:1982824124
Name:BEGLEY, ROSA LEE (CERTIFIDE NURSE AID)
Entity Type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:LEE
Last Name:BEGLEY
Suffix:
Gender:F
Credentials:CERTIFIDE NURSE AID
Other - Prefix:
Other - First Name:ROSA
Other - Middle Name:L
Other - Last Name:BEGLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNA HOME HEALTH AID
Mailing Address - Street 1:4869 UPPER FIVE MILE EAST ROAD
Mailing Address - Street 2:
Mailing Address - City:MT ORAB
Mailing Address - State:OH
Mailing Address - Zip Code:45154
Mailing Address - Country:US
Mailing Address - Phone:937-444-3619
Mailing Address - Fax:
Practice Address - Street 1:4256 UPPER FIVE MILE EAST ROAD
Practice Address - Street 2:
Practice Address - City:MT ORAB
Practice Address - State:OH
Practice Address - Zip Code:45154
Practice Address - Country:US
Practice Address - Phone:937-444-3843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRJ302009374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
2708743Medicare UPIN