Provider Demographics
NPI:1134991631
Name:SE, ROSAMUND (MSC, CALS)
Entity type:Individual
Prefix:MRS
First Name:ROSAMUND
Middle Name:
Last Name:SE
Suffix:
Gender:F
Credentials:MSC, CALS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3869 STAFFORD BLVD
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-3364
Mailing Address - Country:US
Mailing Address - Phone:251-504-9895
Mailing Address - Fax:
Practice Address - Street 1:3869 STAFFORD BLVD
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-3364
Practice Address - Country:US
Practice Address - Phone:251-504-9895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN