Provider Demographics
NPI:1649501743
Name:HORCH, ROSE MARIE (LPN)
Entity type:Individual
Prefix:MISS
First Name:ROSE
Middle Name:MARIE
Last Name:HORCH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1198 MAPLE AVE.
Mailing Address - Street 2:C-7
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14904
Mailing Address - Country:US
Mailing Address - Phone:607-734-3646
Mailing Address - Fax:607-734-3777
Practice Address - Street 1:1198 MAPLE AVE.
Practice Address - Street 2:C-7
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14904
Practice Address - Country:US
Practice Address - Phone:607-734-3646
Practice Address - Fax:607-734-3777
Is Sole Proprietor?:No
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234139164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse