Healthcare Provider Details

I. General information

NPI: 1992546337
Provider Name (Legal Business Name): FRANK D ROSENBERG FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2024
Last Update Date: 08/09/2024
Certification Date: 08/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 E SOUTHERN AVE STE A
TEMPE AZ
85282-7507
US

IV. Provider business mailing address

1301 E UNIVERSITY DR STE 104
TEMPE AZ
85288-8423
US

V. Phone/Fax

Practice location:
  • Phone: 602-283-0080
  • Fax: 602-283-0081
Mailing address:
  • Phone: 602-283-0080
  • Fax: 602-283-0081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number308720
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN113965
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: