Provider Demographics
NPI:1215292420
Name:MCCAFFERTY, ROSE MARIE (ARNP)
Entity type:Individual
Prefix:
First Name:ROSE MARIE
Middle Name:
Last Name:MCCAFFERTY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 LOVELAND BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33980-5716
Mailing Address - Country:US
Mailing Address - Phone:941-629-4500
Mailing Address - Fax:941-624-0174
Practice Address - Street 1:2300 LOVELAND BLVD
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33980-5716
Practice Address - Country:US
Practice Address - Phone:941-629-4500
Practice Address - Fax:941-624-0174
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2666002363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily