Provider Demographics
NPI:1861892630
Name:MOISE, ROSE MONISE (RN)
Entity type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:MONISE
Last Name:MOISE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4908 BLARNEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808
Mailing Address - Country:US
Mailing Address - Phone:517-528-2859
Mailing Address - Fax:407-264-6243
Practice Address - Street 1:4908 BLARNEY DRIVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808
Practice Address - Country:US
Practice Address - Phone:517-528-2859
Practice Address - Fax:407-264-6243
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-29
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9419480163WH1000X, 163WR0400X, 163WS0200X, 163WW0000X, 163WH0200X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No163WS0200XNursing Service ProvidersRegistered NurseSchool
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WH0200XNursing Service ProvidersRegistered NurseHome Health