MEDICARE: AMBER NICOLE ROSE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	735245	PA

General Provider Information

NPI Number	:	1326707415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER NICOLE ROSE

Provider Business Mailing Address
First Line	:	129 W BRENTRIDGE AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15227-3223
Country	:	US
Telephone Number	:	724-787-7835
Fax Number	:

Provider Business Practice Location Address
First Line	:	129 W BRENTRIDGE AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15227-3223
Country	:	US
Telephone Number	:	724-787-7835
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2021
Last Update Date	:	12/15/2021

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Directions to “ AMBER NICOLE ROSE ” Practice Location

Language	Start Address	Practice Location

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