Provider Demographics
NPI:1972298164
Name:DE LA ROSA, ABIGAIL (DNP, APRN, AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:DE LA ROSA
Suffix:
Gender:F
Credentials:DNP, APRN, AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 BARES RUN DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-5901
Mailing Address - Country:US
Mailing Address - Phone:419-953-2298
Mailing Address - Fax:
Practice Address - Street 1:2123 AUBURN AVE
Practice Address - Street 2:MEDICAL OFFICE BUILDING SUITE 122
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-206-1222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031168363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner