Provider Demographics
NPI:1356115679
Name:ABRAHAM, ROSE
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:ABRAHAM
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 1:3479 VALERIE ARMS DR APT 722
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-2139
Mailing Address - Country:US
Mailing Address - Phone:937-960-0280
Mailing Address - Fax:
Practice Address - Street 1:3479 VALERIE ARMS DR APT 722
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-2139
Practice Address - Country:US
Practice Address - Phone:937-960-0280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty