Provider Demographics
NPI:1356769475
Name:ROUSE, JOETTE
Entity type:Individual
Prefix:MRS
First Name:JOETTE
Middle Name:
Last Name:ROUSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOETTE
Other - Middle Name:
Other - Last Name:ROUSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1705 TURTLE POINT DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2747
Mailing Address - Country:US
Mailing Address - Phone:469-285-0688
Mailing Address - Fax:
Practice Address - Street 1:1705 TURTLE POINT DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2747
Practice Address - Country:US
Practice Address - Phone:469-285-0688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-04
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator