Provider Demographics
NPI:1043505126
Name:PRICE, ROSE MARY
Entity type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:MARY
Last Name:PRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 OAKNOLL DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-1936
Mailing Address - Country:US
Mailing Address - Phone:502-966-9065
Mailing Address - Fax:502-966-9065
Practice Address - Street 1:6101 OAKNOLL DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219-1936
Practice Address - Country:US
Practice Address - Phone:502-966-9065
Practice Address - Fax:502-966-9065
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant