Rosa Credle, FNP
Individual provider Active NPI Nurse Practitioner · Winterville, NC
NPI 1043063324 · NPPES record last updated Apr 8, 2024
Key facts
- NPI
- 1043063324
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- CRED-0N34P (NC)
- Practice address
- 468 Channel Dr
Winterville, NC 28590-9196 - Phone
- (252) 258-7544
- NPI assigned
- Apr 8, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 20
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Pruitthealth Hospice Inc
Practice addresses (Care Compare)
2313 Executive Cir
Suite a
Greenville, NC 27834-3744
Phone (252) 753-7741
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260220002504 | NC | Practitioner - Nurse Practitioner | 1254812985 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CRED-0N34P | NC | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pruitthealth Hospice, Inc. | Current |
Accepting new patients | |
| Physicians at Home PC | Past |
Accepting new patients |
Locations
1626 Jeurgens Ct
Norcross, GA 30093
Phone (770) 806-6875
2313 Executive Cir
Ste A
Greenville, NC 27834
Phone (252) 751-7741
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | CRED-0N34P | NC | Yes |
Addresses
Primary practice location
468 Channel Dr
Winterville, NC 28590-9196
Mailing address
468 Channel Dr
Winterville, NC 28590-9196
Phone (252) 258-7544
Other providers in Winterville, NC
- Lisa Coffey
- Lisa Kay Coffman
- Community Focused Health LLC
- Nicole Victoria Compton
- Veronica Alexandria Cary Cox
- Christopher Justin Crotty
- Reagan Grace Cunningham
- CVS/Pharmacy
- Dae LLC
- Frank Dang
All providers in Winterville, NC · Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.