Healthcare Provider Details

I. General information

NPI: 1477013167
Provider Name (Legal Business Name): LYNNE MICHELLE ROSENBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 02/13/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ADVENTHEALTH MEDICAL GROUP HOSPITALISTS AT PARKER 9395 CROWN CREST BLVD
PARKER CO
80138-8573
US

IV. Provider business mailing address

PORTERCARE ADVENTIST HEALTH SYSTEM 9395 CROWN CREST BLVD
PARKER CO
80138-8573
US

V. Phone/Fax

Practice location:
  • Phone: 303-269-4000
  • Fax: 303-269-4070
Mailing address:
  • Phone: 303-269-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PT0002X
TaxonomyMedical Toxicology (Emergency Medicine) Physician
License NumberDR.0070690
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDR.0070690
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.70690
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: