Individual provider · Type 1 NPI

Walter Samuel Rose Ii

Student in an Organized Health Care Education/Training Program · Jackson, MS

NPI number 1720666282 Active

Practice location

3805 Crane Blvd
Jackson, MS 39216-3608

Call (662) 207-7268 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1720666282

Walter Samuel Rose Ii's National Provider Identifier is 1720666282, issued on Mar 29, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Jackson, MS. The record was last updated on Mar 29, 2021.