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NPI Code Detail

MEDICARE: COREY ROSE APRN

MEDICARE: COREY ROSE APRN
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
1363LC0200XCritical Care Medicine Nurse Practitioner490199OH

General Provider Information

NPI Number : 1669335576
Entity Type Code : Individual
Provider Name (Legal Business Name) : COREY ROSE APRN
Provider Business Mailing Address
First Line : 8365 MAIN ST
Second Line :
City : KINSMAN
State : OH
Zip : 44428-9326
Country : US
Telephone Number : 863-327-2447
Fax Number :
Provider Business Practice Location Address
First Line : 11100 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1716
Country : US
Telephone Number : 216-844-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2025
Last Update Date : 01/24/2026

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Directions to “ COREY ROSE APRN” Practice Location

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