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NPI Code Detail

MEDICARE: MRS. ROSE ELLEN SIEBENHAAR RN

MEDICARE: MRS. ROSE ELLEN SIEBENHAAR RN
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
1163W00000XRegistered NurseRN.286123OH

General Provider Information

NPI Number : 1730536830
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ROSE ELLEN SIEBENHAAR RN
Provider Business Mailing Address
First Line : 340 S BROADWAY ST
Second Line :
City : AKRON
State : OH
Zip : 44308-1529
Country : US
Telephone Number : 330-263-3100
Fax Number : 330-376-8002
Provider Business Practice Location Address
First Line : 10 PENFIELD AVE
Second Line :
City : AKRON
State : OH
Zip : 44310-2912
Country : US
Telephone Number : 330-762-6110
Fax Number : 330-253-6810
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2016
Last Update Date : 05/18/2016

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