Provider Demographics
NPI:1144519919
Name:HENRY, ROSEMARIE J (MED-ASS/CNA/HHA)
Entity type:Individual
Prefix:MS
First Name:ROSEMARIE
Middle Name:J
Last Name:HENRY
Suffix:
Gender:F
Credentials:MED-ASS/CNA/HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4540 PORTOFINO WAY APT 203
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-8105
Mailing Address - Country:US
Mailing Address - Phone:561-713-4533
Mailing Address - Fax:
Practice Address - Street 1:4540 PORTOFINO WAY APT 203
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-8105
Practice Address - Country:US
Practice Address - Phone:561-713-4533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2345167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician