Healthcare Provider Details

I. General information

NPI: 1003039900
Provider Name (Legal Business Name): ROSALINDA ROSSOW FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 W UNIVERSITY DR ESRH STUDENT HEALTH SERVICES
EDINBURG TX
78539-2909
US

IV. Provider business mailing address

7304 N 30TH ST
MCALLEN TX
78504-4988
US

V. Phone/Fax

Practice location:
  • Phone: 956-381-2511
  • Fax: 956-381-2512
Mailing address:
  • Phone: 956-630-1405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number255170
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: