Healthcare Provider Details

I. General information

NPI: 1376478057
Provider Name (Legal Business Name): LAUREN CHRISTINE ROSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 N KENSINGTON PL
SPRINGFIELD OH
45504-1028
US

IV. Provider business mailing address

133 N KENSINGTON PL
SPRINGFIELD OH
45504-1028
US

V. Phone/Fax

Practice location:
  • Phone: 937-207-6862
  • Fax:
Mailing address:
  • Phone: 937-207-6862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: