Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Walter Samuel Rose II

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1720666282

Walter Samuel Rose II is a Student in an Organized Health Care Education/Training Program in Jackson, Mississippi. Licensed in Mississippi. Registered with an NPI since 2021.

Licensed in
MS
In the registry since
2021

Practice location Address checks out

3805 Crane Blvd
Jackson, MS 39216-3608
Phone: (662) 207-7268
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (MS)

Record details

NPI number1720666282
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 29, 2021
Last updated in NPPESMarch 29, 2021
Certification dateMarch 29, 2021

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