=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477013167
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LYNNE MICHELLE ROSENBERG
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/20/2019
-----------------------------------------------------
Last Update Date | 02/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | ADVENTHEALTH MEDICAL GROUP HOSPITALISTS AT PARKER 9395 CROWN CREST BLVD
-----------------------------------------------------
City | PARKER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80138-8573
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-269-4000
-----------------------------------------------------
Fax | 303-269-4070
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PORTERCARE ADVENTIST HEALTH SYSTEM 9395 CROWN CREST BLVD
-----------------------------------------------------
City | PARKER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80138-8573
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-269-4000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207PT0002X
-----------------------------------------------------
Taxonomy Name | Medical Toxicology (Emergency Medicine) Physician
-----------------------------------------------------
License Number | DR.0070690
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | DR.0070690
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | DR.70690
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------