Rosanne Dover
Individual provider Active NPI Pediatric Nurse Practitioner · Del City, OK
NPI 1124174362 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124174362
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- R0032466 (OK)
- Practice address
- 3851 Tinker Diagonal St
Del City, OK 73115-2109 - Phone
- (405) 677-1129
- Fax
- (405) 677-8991
- NPI assigned
- Jan 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0032466 | OK | MD | Pediatric Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | R0032466 | OK | Yes |
Addresses
Primary practice location
3851 Tinker Diagonal St
Del City, OK 73115-2109
Mailing address
500 NW 40TH St
Oklahoma City, OK 73118-7042
Other providers in Del City, OK
- Dental Depot Orthodontics del City, PLLC
- Janet Kathryn Diehl
- Holly Dinh
- Steven Wayne Ditto
- Tracy DO
- Oyinkansola Doyin-Lipede
- Cordero Draper
- Simone' M Driggins
- Daren Dugger
- Jennifer Durham
All providers in Del City, OK · Pediatric Nurse Practitioner in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.