Provider Demographics
NPI:1710078159
Name:ROSENBERGER, AMY TEMPLE (RN, BSN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:TEMPLE
Last Name:ROSENBERGER
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 BOSLEY RD
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:NC
Mailing Address - Zip Code:27979-9601
Mailing Address - Country:US
Mailing Address - Phone:252-331-3269
Mailing Address - Fax:
Practice Address - Street 1:711 ROANOKE AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-5643
Practice Address - Country:US
Practice Address - Phone:252-338-4400
Practice Address - Fax:252-338-4440
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC183712163WD0400X
NC5013946363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator