Provider Demographics
NPI:1750630828
Name:ANDERSON, ROSIE M (LIMHP)
Entity Type:Individual
Prefix:
First Name:ROSIE
Middle Name:M
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1209
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69103-1209
Mailing Address - Country:US
Mailing Address - Phone:308-534-6029
Mailing Address - Fax:308-534-6961
Practice Address - Street 1:307 E 5TH ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NE
Practice Address - Zip Code:68850-2110
Practice Address - Country:US
Practice Address - Phone:308-324-6754
Practice Address - Fax:308-324-5118
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3188101YM0800X
NE68101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health