Provider Demographics
NPI:1144493321
Name:DRAGONE, ROSEMARY HEATHER
Entity type:Individual
Prefix:MISS
First Name:ROSEMARY
Middle Name:HEATHER
Last Name:DRAGONE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ROSEMARY
Other - Middle Name:HEATHER
Other - Last Name:DRAGONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:341 N MARVINE AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-2942
Mailing Address - Country:US
Mailing Address - Phone:315-253-8204
Mailing Address - Fax:
Practice Address - Street 1:341 N MARVINE AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-2942
Practice Address - Country:US
Practice Address - Phone:315-253-8204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1513321164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse