Healthcare Provider Details

I. General information

NPI: 1962900159
Provider Name (Legal Business Name): AMBER MARIE ROSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2018
Last Update Date: 09/16/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3219 CLIFTON AVE STE 210
CINCINNATI OH
45220-3041
US

IV. Provider business mailing address

4685 FOREST AVE STE C
CINCINNATI OH
45212-3359
US

V. Phone/Fax

Practice location:
  • Phone: 513-751-5900
  • Fax: 513-487-4590
Mailing address:
  • Phone: 513-853-4731
  • Fax: 513-852-8525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN.373294
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: