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General NPI Number Information
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NPI Number | 1053132449
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Entity Type | Individual
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Provider Name | STACI NICOLE ROSEN APRN
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Gender | Female
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Dates
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Enumeration Date | 10/18/2024
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 1840 MEASE DR STE 202
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City | SAFETY HARBOR
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State | FL
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Zip | 34695-6604
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Country | US
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Telephone | 727-725-6246
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Fax |
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Provider Business Mailing Address
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Address Line | 3232 BROOKSIDE CT
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City | TARPON SPGS
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State | FL
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Zip | 34688-9224
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Country | US
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Telephone | 860-336-6947
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 11036027
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License Number State | FL
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