Provider Demographics
NPI:1043033962
Name:GONZALEZ-MARCHBANKS, ROSE MIRLANDE (CNA,CHHA)
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:MIRLANDE
Last Name:GONZALEZ-MARCHBANKS
Suffix:
Gender:F
Credentials:CNA,CHHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3828 EXMOOR RD
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-3827
Mailing Address - Country:US
Mailing Address - Phone:970-701-1667
Mailing Address - Fax:
Practice Address - Street 1:3828 EXMOOR RD
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-3827
Practice Address - Country:US
Practice Address - Phone:970-701-1667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00778225376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty