Provider Demographics
NPI:1205081163
Name:HALSTEAD, ROSE M (RN)
Entity type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:M
Last Name:HALSTEAD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 VIRGINIA AVE.
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:15074-1723
Mailing Address - Country:US
Mailing Address - Phone:724-775-5208
Mailing Address - Fax:724-770-8259
Practice Address - Street 1:176 VIRGINIA AVENUE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:PA
Practice Address - Zip Code:15074-1723
Practice Address - Country:US
Practice Address - Phone:724-775-5208
Practice Address - Fax:724-770-8259
Is Sole Proprietor?:No
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN508742L163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health