Healthcare Provider Details

I. General information

NPI: 1619960697
Provider Name (Legal Business Name): KIMBRA A ROSENBERG ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E 8TH ST
LARNED KS
67550-2602
US

IV. Provider business mailing address

623 W 6TH ST
LARNED KS
67550-2920
US

V. Phone/Fax

Practice location:
  • Phone: 620-285-6424
  • Fax: 620-285-3660
Mailing address:
  • Phone: 620-285-2836
  • Fax: 620-285-3660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number74245
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number74245
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: