Healthcare Provider Details

I. General information

NPI: 1396871331
Provider Name (Legal Business Name): ROSEMARY HENRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5880 BRADFORD HICKS DR TN DEPT OF HEALTH
LIVINGSTON TN
38570-2236
US

IV. Provider business mailing address

147 LARRY DUDNEY LN
GAINESBORO TN
38562-5794
US

V. Phone/Fax

Practice location:
  • Phone: 931-823-6260
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: