Provider Demographics
NPI:1801822390
Name:ROSS, LOUISE A
Entity type:Individual
Prefix:MRS
First Name:LOUISE
Middle Name:A
Last Name:ROSS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:LOUISE
Other - Middle Name:A
Other - Last Name:BROUDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:5350 HARRISON RD
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-6647
Mailing Address - Country:US
Mailing Address - Phone:530-872-8341
Mailing Address - Fax:
Practice Address - Street 1:111 RALEY BLVD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-8351
Practice Address - Country:US
Practice Address - Phone:530-332-9703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA473374163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn