Provider Demographics
NPI:1912513664
Name:PALANCA, ROSALINA ANN
Entity type:Individual
Prefix:
First Name:ROSALINA
Middle Name:ANN
Last Name:PALANCA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12240 MOSS POINT RD
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-3506
Mailing Address - Country:US
Mailing Address - Phone:440-465-3448
Mailing Address - Fax:
Practice Address - Street 1:12240 MOSS POINT RD
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-3506
Practice Address - Country:US
Practice Address - Phone:440-465-3448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH602252240920374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide