Provider Demographics
NPI:1386410108
Name:MAKEMTEH, ROSEMARY (NP)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:MAKEMTEH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16850 CABERNET CT
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-7064
Mailing Address - Country:US
Mailing Address - Phone:408-206-3840
Mailing Address - Fax:
Practice Address - Street 1:16850 CABERNET CT
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-7064
Practice Address - Country:US
Practice Address - Phone:408-206-3840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95024239363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty