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NPI Code Detail

MEDICARE: MARLENE ROSANA

MEDICARE:   MARLENE  ROSANA
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
1363LF0000XFamily Nurse PractitionerAP129672TX

General Provider Information

NPI Number : 1861866204
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLENE ROSANA
Provider Business Mailing Address
First Line : 1806 W PLEASANT RIDGE RD
Second Line :
City : ARLINGTON
State : TX
Zip : 76015-4530
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1806 W PLEASANT RIDGE RD
Second Line :
City : ARLINGTON
State : TX
Zip : 76015-4530
Country : US
Telephone Number : 817-635-6363
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2015
Last Update Date : 11/23/2015

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Directions to “ MARLENE ROSANA ” Practice Location

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