Individual provider · Type 1 NPI

Blair Nicole Rose, PA-C

Medical Physician Assistant · Dallas, TX

NPI number 1497059034 Active

Practice location

1717 Main St, 5200
Dallas, TX 75201-4612

Mailing address

804 Andersonville Ln
Wylie, TX 75098-5304

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1497059034

Blair Nicole Rose, PA-C's National Provider Identifier is 1497059034, issued on Dec 22, 2010. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Dallas, TX. The record was last updated on Dec 22, 2010.