Provider Demographics
NPI:1194904235
Name:JANSSEN, ROSE ANNE (CMT)
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:ANNE
Last Name:JANSSEN
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 E MINNESOTA ST
Mailing Address - Street 2:PO BOX 188
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MN
Mailing Address - Zip Code:56374-8618
Mailing Address - Country:US
Mailing Address - Phone:320-363-7460
Mailing Address - Fax:
Practice Address - Street 1:1511 E MINNESOTA ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MN
Practice Address - Zip Code:56374-8618
Practice Address - Country:US
Practice Address - Phone:320-363-7460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist