Healthcare Provider Details

I. General information

NPI: 1407677883
Provider Name (Legal Business Name): HUNTER ROSE OPANEL MSN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HUNTER ROSE PELLEGRINI

II. Dates (important events)

Enumeration Date: 10/18/2024
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16900 ALGONQUIN ST APT 7
HUNTINGTON BEACH CA
92649-3833
US

IV. Provider business mailing address

16900 ALGONQUIN ST APT 7
HUNTINGTON BEACH CA
92649-3833
US

V. Phone/Fax

Practice location:
  • Phone: 559-960-3750
  • Fax:
Mailing address:
  • Phone: 559-960-3750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95032535
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: