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General NPI Number Information
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NPI Number | 1316609548
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Entity Type | Individual
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Provider Name | ISABEL BURICK ROSE
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Gender | Female
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Dates
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Enumeration Date | 10/05/2021
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 10710 CHARTER DR STE G020
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City | COLUMBIA
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State | MD
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Zip | 21044-3257
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Country | US
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Telephone | 410-964-2212
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Fax |
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Provider Business Mailing Address
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Address Line | 5154 PERRY RD
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City | MOUNT AIRY
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State | MD
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Zip | 21771-8823
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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