Provider Demographics
NPI:1295589463
Name:BORGARD, ROSE DARLINE (RN)
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:DARLINE
Last Name:BORGARD
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 1:6303 YULEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:NY
Mailing Address - Zip Code:13039-9251
Mailing Address - Country:US
Mailing Address - Phone:347-909-5789
Mailing Address - Fax:
Practice Address - Street 1:6303 YULEWOOD CIR
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:NY
Practice Address - Zip Code:13039-9251
Practice Address - Country:US
Practice Address - Phone:347-909-5789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY886301163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health