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General NPI Number Information
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NPI Number | 1639302417
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Entity Type | Organization
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Legal Business Name | ROSEWOOD PROFESSIONAL CENTER, LLC
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Dates
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Enumeration Date | 08/27/2009
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Last Update Date | 02/07/2011
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Provider Practice Location Address
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Address Line | 414 E. WOODIN AVE
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City | CHELAN
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State | WA
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Zip | 98816-9648
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Country | US
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Telephone | 509-888-2209
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Fax | 509-888-9449
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Provider Business Mailing Address
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Address Line | PO BOX 1719
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City | CHELAN
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State | WA
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Zip | 98816-1719
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Country | US
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Telephone | 509-888-2209
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Fax | 509-888-9449
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Authorized Official
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Title or Position | OWNER
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Name | KERRI LESLIE KREMER
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Credential | ARNP, RNFA
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Telephone | 509-679-2276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP60045990
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP60045990
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | RN00095775
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | RN00095775
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License Number State | WA
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