Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | COA.13402-NP | OH |
N | 363LF0000X | Nurse Practitioner - Family Medicine | COA.13402 | OH |
NPI | 1003179821 |
---|---|
Provider Name | Larry L Rosenberger II |
First Address | Findlay, OH 45840-8738 |
Second Address | Findlay, OH 45840-8738 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2012 |
Last Update Date | 20/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0066679 | (05) | OH |