LISA S ROSE, FNP-C, Primary Care DUBOIS, WY

Contact Information

LISA S ROSE, FNP-C

5647 US HIGHWAY 26
DUBOIS, WY 82513-9607

Phone: 307-455-2516
Fax: 307-455-2526
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Primary Care	363LP2300X	50	Nurse Practitioner

Indicates primary specialty

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NPI Profile & details for LISA S ROSE · (Female)

NPI Number	`1659734390`
Status	Active
Credentials	FNP-C (Family Nurse Practitioner, Certified)
Entity	Individual
Enumeration date	03/31/2016
Last updated	03/22/2022 - About 4 years ago
Sole proprietor ¹	No
Identifiers	WY License # 22672.1509 WY Medicaid 144824200
Hospital affiliation(s)	RIVERTON MEMORIAL HOSPITAL - (Acute Care) 2100 W SUNSET DR RIVERTON, WY 82501 ST JOHNS MEDICAL CENTER - (Acute Care) 625 EAST BROADWAY JACKSON, WY 83001

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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