Provider Demographics
NPI:1740643576
Name:LEWIS, ROSE MARIE (DNP,ARNP-FNP-BC)
Entity type:Individual
Prefix:DR
First Name:ROSE
Middle Name:MARIE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:DNP,ARNP-FNP-BC
Other - Prefix:DR
Other - First Name:ROSE
Other - Middle Name:MARIE
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP, ARNP, FNP-BC
Mailing Address - Street 1:4460 NW 42ND TER
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4720
Mailing Address - Country:US
Mailing Address - Phone:954-295-8458
Mailing Address - Fax:
Practice Address - Street 1:4460 NW 42ND TER
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4720
Practice Address - Country:US
Practice Address - Phone:954-295-8458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3066462163WC1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege Health