Patricia Sue Rose-Liana, FNP
Individual provider Active NPI Family Nurse Practitioner · Vandalia, MO
NPI 1124141114 · NPPES record last updated Sep 12, 2024
Key facts
- NPI
- 1124141114
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4704109906 (MI)
- Practice address
- 425 N Galloway Rd
Vandalia, MO 63382-1259 - Phone
- (573) 594-2111
- NPI assigned
- Apr 6, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pike County Memorial Hospital
Practice addresses (Care Compare)
1420 S Business
Bowling Green, MO 63334-5230
Phone (573) 324-5562
425 N Galloway Rd
Vandalia, MO 63382-1259
Phone (573) 594-2111
Hospital & facility affiliations
- Pike County Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- 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 |
|---|---|---|---|---|
| I20101013001017 | MO | Practitioner - Nurse Practitioner | 0547207482 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704109906 | MI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pike County Memorial Hospital | Current |
Accepting new patients | |
| Pike County Memorial Hospital | Current |
Accepting new patients | |
| Pike County Memorial Hospital | Current | Accepting new patients | |
| Pike County Memorial Hospital | Current |
Accepting new patients |
Locations
1015 W Adams St
Bowling Green, MO 63334
Phone (573) 324-5300
2305 Georgia St
Louisiana, MO 63353
Phone (573) 754-4584
425 N Galloway Rd
Vandalia, MO 63382
Phone (573) 594-2111
Interoperability endpoints
- proseliana@pike.cernerdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704109906 | MI | Yes |
Addresses
Primary practice location
425 N Galloway Rd
Vandalia, MO 63382-1259
Mailing address
102, Wintergreen
Marquette, MI 49855
Phone (906) 249-5243
Other practice location 1
1414 W Fair Ave
#332
Marquette, MI 49855-2675
Phone (906) 225-6960
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | proseliana@pike.cernerdirect.com | Direct |
Other providers in Vandalia, MO
- Alexandria McCandless
- Katlyn Renee Meyers
- Niemann Foods Inc
- Pike County Memorial Hospital
- Pike County Memorial Hospital
- Joseph Salois
- Teresa L Stice
- The Baptist Home
- The Baptist Homes
- Tri County Nursing Home District
All providers in Vandalia, MO · Family Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 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.