Healthcare Provider Details

I. General information

NPI: 1952813461
Provider Name (Legal Business Name): ROSA CAMA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2017
Last Update Date: 10/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 BURNET AVE
CINCINNATI OH
45229-3014
US

IV. Provider business mailing address

6929 LYNNFIELD CT APT 104
CINCINNATI OH
45243-1731
US

V. Phone/Fax

Practice location:
  • Phone: 513-357-7200
  • Fax:
Mailing address:
  • Phone: 513-334-9093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number420214
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: