Individual provider · Type 1 NPI

Crystal Rose

Licensed Practical Nurse · Portland, OR

NPI number 1235849555 Active

Practice location

9750 NE Glisan St
Portland, OR 97220-4449

Mailing address

17180 W Sweetwater Ave Unit 1088
Surprise, AZ 85388-3404

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000X202209494 (OR)
Licensed Practical Nurse Primary 164W00000X202209494 (OR)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1235849555

Crystal Rose's National Provider Identifier is 1235849555, issued on Nov 28, 2022. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Portland, OR. The record was last updated on Apr 17, 2024.