| Rose Kihara Nurse Practitioner Llc | |
|
39 Route 171 Woodstock CT 06281 | |
| (860) 776-0187 | |
| Not Available |
| Full Name | Rose Kihara Nurse Practitioner Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 39 Route 171, Woodstock, Connecticut |
| Authorized Official Name and Position | Rose Kihara (APRN) |
| Authorized Official Contact | 8603151198 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rose Kihara Nurse Practitioner Llc Po Box 922 Woodstock CT 06281-3044 Ph: (860) 315-1198 | Rose Kihara Nurse Practitioner Llc 39 Route 171 Woodstock CT 06281 Ph: (860) 776-0187 |
| NPI Number | 1952890105 |
|---|---|
| Provider Enumeration Date | 05/03/2018 |
| Last Update Date | 04/03/2020 |
| Certification Date | 04/03/2020 |
| Medicare PECOS PAC ID | 4486904950 |
|---|---|
| Medicare Enrollment ID | O20180904001444 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952890105 | NPI | - | NPPES |
| 008023376 | Medicaid | CT |
| Provider Name | Rose Kihara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649506445 PECOS PAC ID: 7416128020 Enrollment ID: I20110912000235 |
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