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General NPI Number Information
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NPI Number | 1710886353
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Entity Type | Organization
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Legal Business Name | ROSE LEGACY HEALTH GROUP, LLC
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Dates
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Enumeration Date | 11/02/2026
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Last Update Date | 11/02/2026
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Provider Practice Location Address
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Address Line | 5457 TWIN KNOLLS RD STE 300
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City | COLUMBIA
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State | MD
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Zip | 21045-3296
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Country | US
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Telephone | 301-802-8508
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Fax |
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Provider Business Mailing Address
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Address Line | 734 APPLE ORCHARD DR
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City | GLEN BURNIE
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State | MD
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Zip | 21060-8590
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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 | MANAGING MEMBER
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Name | MRS. BENDU JOHNSON
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Credential | MSN, APRN, FNP-BC
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Telephone | 301-802-8508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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