Provider Demographics
NPI:1730623638
Name:LACAS, ROSEANNA KATHERINE (EMT-B)
Entity type:Individual
Prefix:
First Name:ROSEANNA
Middle Name:KATHERINE
Last Name:LACAS
Suffix:
Gender:F
Credentials:EMT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 RUSSELL RD
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-2141
Mailing Address - Country:US
Mailing Address - Phone:413-209-4952
Mailing Address - Fax:
Practice Address - Street 1:263 ALDEN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01109-3707
Practice Address - Country:US
Practice Address - Phone:413-209-4952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer