Healthcare Provider Details

I. General information

NPI: 1730292897
Provider Name (Legal Business Name): ROSEMARIE MILANO ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROSE MILANO ARNP

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 05/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3181 SW SAM JACKSON PARK RD
PORTLAND OR
97239-3011
US

IV. Provider business mailing address

3181 SW SAM JACKSON PARK RD
PORTLAND OR
97239-3011
US

V. Phone/Fax

Practice location:
  • Phone: 503-494-8311
  • Fax:
Mailing address:
  • Phone: 503-494-8311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number111370
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberL111370
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number201350051NP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: