Provider Demographics
NPI:1467042671
Name:NIEMI, ROSA LINDA (APRN)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:LINDA
Last Name:NIEMI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ROSA
Other - Middle Name:LINDA
Other - Last Name:MERGENTHAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1761 COMMONS NORTH LOOP UNIT 4101
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-3591
Mailing Address - Country:US
Mailing Address - Phone:907-650-7223
Mailing Address - Fax:
Practice Address - Street 1:1720 KNOWLES RD
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36869-7135
Practice Address - Country:US
Practice Address - Phone:334-291-0485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-182024363LF0000X
AK161692363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily