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General NPI Number Information
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NPI Number | 1275351652
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Entity Type | Individual
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Provider Name | ROSE MARIE DESROSIERS RN
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Gender | Female
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 11 CALDWELL ROAD
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City | AUGUSTA
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State | ME
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Zip | 04330-5227
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Country | US
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Telephone | 207-213-2037
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Fax |
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Provider Business Mailing Address
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Address Line | 127 OAKLAND RD
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City | FAIRFIELD
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State | ME
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Zip | 04937-3229
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Country | US
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Telephone | 207-649-2457
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 026307
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License Number State | ME
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