Healthcare Provider Details

I. General information

NPI: 1346827722
Provider Name (Legal Business Name): PATRICIA ROSENBERRY AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 LUBRANO DR STE 111
ANNAPOLIS MD
21401-7192
US

IV. Provider business mailing address

14995 SHADY GROVE RD STE 100
ROCKVILLE MD
20850-8733
US

V. Phone/Fax

Practice location:
  • Phone: 410-974-8332
  • Fax:
Mailing address:
  • Phone: 301-869-7820
  • Fax: 301-762-2541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR173447
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberR173447
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: