Healthcare Provider Details

I. General information

NPI: 1821519760
Provider Name (Legal Business Name): HEATHER ROSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HEATHER ROSE KARCHEFSKI

II. Dates (important events)

Enumeration Date: 06/30/2017
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 E PRATER WAY STE 107
SPARKS NV
89434-8963
US

IV. Provider business mailing address

2972 FOX TRAIL DR
RENO NV
89523-3254
US

V. Phone/Fax

Practice location:
  • Phone: 775-825-4744
  • Fax: 775-351-1644
Mailing address:
  • Phone: 775-250-5445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP-2125
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: