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General NPI Number Information
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NPI Number | 1205628237
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Entity Type | Individual
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Provider Name | MAKENZY ALEXIS ROSENBERGER
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Gender | Female
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Dates
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Enumeration Date | 05/17/2025
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Last Update Date | 05/17/2025
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Provider Practice Location Address
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Address Line | 2301 W 1ST ST
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City | ANKENY
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State | IA
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Zip | 50023-2470
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Country | US
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Telephone | 515-304-4263
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Fax |
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Provider Business Mailing Address
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Address Line | 803 CLEVELAND AVE SE
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City | BONDURANT
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State | IA
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Zip | 50035-2014
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Country | US
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Telephone | 641-990-5606
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A182040
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License Number State | IA
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