Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | AP145102 | TX |
NPI | 1073160453 |
---|---|
Provider Name | Hailey Rosenberg |
First Address | Bellaire, TX 77401-4104 |
Second Address | Bellaire, TX 77401-4104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2019 |
Last Update Date | 19/06/2020 |