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General NPI Number Information
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NPI Number | 1982391835
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Entity Type | Individual
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Provider Name | CATHERINE MARIE ROSE FNP-C, APRN, CNP, RN
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Gender | Female
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Dates
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Enumeration Date | 04/20/2023
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 3017 WILMINGTON PIKE STE C
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City | KETTERING
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State | OH
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Zip | 45429-4169
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Country | US
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Telephone | 937-800-8990
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Fax | 937-294-5755
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Provider Business Mailing Address
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Address Line | PO BOX 292168
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City | KETTERING
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State | OH
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Zip | 45429-0168
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Country | US
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Telephone | 937-800-8990
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Fax | 937-294-5755
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.0033310
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License Number State | OH
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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 | APRN.CNP.0033310
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APRN.CNP.0033310
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License Number State | OH
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