Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | RN67846 | DC |
NPI | 1124442041 |
---|---|
Provider Name | Ms. Grace Rosario |
First Address | Washington, DC 20060-0001 |
Second Address | Washington, DC 20060-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2014 |
Last Update Date | 12/02/2014 |