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NPI Code Detail

MEDICARE: BARBARA S DEROSE NP

MEDICARE: BARBARA S DEROSE NP
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 Nurse28072442AIN
2363L00000XNurse Practitioner71002477AIN

General Provider Information

NPI Number : 1902021892
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA S DEROSE NP
Provider Business Mailing Address
First Line : 4464 SILVER HILL DR
Second Line :
City : GREENWOOD
State : IN
Zip : 46142-9665
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11020 PENDLETON PIKE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46236-2817
Country : US
Telephone Number : 317-826-3903
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2007
Last Update Date : 01/28/2025

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