Healthcare Provider Details

I. General information

NPI: 1457461592
Provider Name (Legal Business Name): ROSA LANE HOOD BSN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 09/29/2026
Certification Date:
Deactivation Date: 02/09/2007
Reactivation Date: 10/03/2007

III. Provider practice location address

521 N BRIGHTLEAF BLVD JOHNSTON COUNTY MENTAL HEALTH CENTER
SMITHFIELD NC
27577
US

IV. Provider business mailing address

PO BOX 411 JOHNSTON COUNTY MENTAL HEALTH CENTER
SMITHFIELD NC
27577-0411
US

V. Phone/Fax

Practice location:
  • Phone: 919-989-5500
  • Fax: 919-989-5532
Mailing address:
  • Phone: 919-989-5500
  • Fax: 919-989-5532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number063890
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: