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General NPI Number Information
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NPI Number | 1871341826
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Entity Type | Individual
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Provider Name | JASMINE ROSE
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Gender | Female
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Dates
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Enumeration Date | 05/07/2024
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 1809 CLARENDON AVE
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City | BESSEMER
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State | AL
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Zip | 35020-5843
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Country | US
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Telephone | 205-253-7891
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1404
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City | HANNIBAL
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State | MO
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Zip | 63401-1404
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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 | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 2022044538
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License Number State | MO
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