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NPI Code Detail

MEDICARE: MARY CARR ROSS APNP

MEDICARE: MARY CARR ROSS APNP
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
1363LX0001XObstetrics & Gynecology Nurse Practitioner24-033WI
2363L00000XNurse Practitioner24WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821071150
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY CARR ROSS APNP
Provider Business Mailing Address
First Line : 1821 S STOUGHTON RD
Second Line :
City : MADISON
State : WI
Zip : 53716-2257
Country : US
Telephone Number : 608-260-6000
Fax Number : 608-260-6835
Provider Business Practice Location Address
First Line : 1821 S STOUGHTON RD
Second Line :
City : MADISON
State : WI
Zip : 53716-2257
Country : US
Telephone Number : 608-260-6000
Fax Number : 608-260-6835
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2005
Last Update Date : 12/17/2020

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