Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 0101256899 | VA |
NPI | 1013176437 |
---|---|
Provider Name | Kristi Hackworth Rose |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22908-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2008 |
Last Update Date | 10/02/2022 |