Provider Demographics
NPI:1053101071
Name:BELFRAGE, ROSE
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:BELFRAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:BERENS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1909 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:BLAIR
Mailing Address - State:NE
Mailing Address - Zip Code:68008-1524
Mailing Address - Country:US
Mailing Address - Phone:712-898-4216
Mailing Address - Fax:
Practice Address - Street 1:1909 FRONT ST
Practice Address - Street 2:
Practice Address - City:BLAIR
Practice Address - State:NE
Practice Address - Zip Code:68008-1524
Practice Address - Country:US
Practice Address - Phone:402-720-7788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider