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NPI Code Detail

MEDICARE: MRS. DEBORAH JOYCE ROSENGREN R.N.

MEDICARE: MRS. DEBORAH JOYCE ROSENGREN R.N.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WH0200XHome Health Registered NurseR 107825-1MN

General Provider Information

NPI Number : 1619194081
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEBORAH JOYCE ROSENGREN R.N.
Provider Business Mailing Address
First Line : 1408 MAPLE GROVE RD
Second Line : #604
City : DULUTH
State : MN
Zip : 55811-4571
Country : US
Telephone Number : 218-720-6254
Fax Number :
Provider Business Practice Location Address
First Line : 1408 MAPLE GROVE RD
Second Line : #604
City : DULUTH
State : MN
Zip : 55811-4571
Country : US
Telephone Number : 218-720-6254
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2007
Last Update Date : 07/08/2007

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