Provider Demographics
NPI:1336430834
Name:BUCHANAN, ROSE WARNETTA
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:WARNETTA
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10150 OSAGE CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89508-8168
Mailing Address - Country:US
Mailing Address - Phone:775-972-1896
Mailing Address - Fax:
Practice Address - Street 1:10150 OSAGE CT
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89508-8168
Practice Address - Country:US
Practice Address - Phone:775-972-1896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner