Provider Demographics
NPI:1750402335
Name:ROSE, RENEE ARLENE
Entity type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:ARLENE
Last Name:ROSE
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 1:935 S 16TH ST
Mailing Address - Street 2:
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-2709
Mailing Address - Country:US
Mailing Address - Phone:740-295-0581
Mailing Address - Fax:740-295-0581
Practice Address - Street 1:935 S 16TH ST
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-2709
Practice Address - Country:US
Practice Address - Phone:740-295-0581
Practice Address - Fax:740-295-0581
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide