Provider Demographics
NPI:1578546800
Name:ROSE, LINDA HARNSBERGER (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:HARNSBERGER
Last Name:ROSE
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 HUGUENOT RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-2618
Mailing Address - Country:US
Mailing Address - Phone:804-794-2299
Mailing Address - Fax:804-794-5774
Practice Address - Street 1:1407 HUGUENOT RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-2618
Practice Address - Country:US
Practice Address - Phone:804-794-2299
Practice Address - Fax:804-794-5774
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024107707363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner