Provider Demographics
NPI:1932686136
Name:ROSENBERG, ALAINE KAY (APNP)
Entity Type:Individual
Prefix:
First Name:ALAINE
Middle Name:KAY
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1166 TILLUNG RD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:WI
Mailing Address - Zip Code:53523-9452
Mailing Address - Country:US
Mailing Address - Phone:608-216-4117
Mailing Address - Fax:
Practice Address - Street 1:2955 TRIVERTON PIKE DR
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-5807
Practice Address - Country:US
Practice Address - Phone:608-227-7007
Practice Address - Fax:608-227-7027
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-20
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8513-33363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty