Provider Demographics
NPI:1982488599
Name:ROSE, MEGAN ELIZABETH
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:ELIZABETH
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 1:940 SPRING PARK ST APT 302
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-4466
Mailing Address - Country:US
Mailing Address - Phone:347-628-3998
Mailing Address - Fax:
Practice Address - Street 1:940 SPRING PARK ST APT 302
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-4466
Practice Address - Country:US
Practice Address - Phone:347-628-3998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider