Provider Demographics
NPI:1023051141
Name:PARKHURST GATEWOOD, ROSEANNA L (FNP)
Entity type:Individual
Prefix:
First Name:ROSEANNA
Middle Name:L
Last Name:PARKHURST GATEWOOD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 BELLEMEADE AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-0126
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3700 BELLEMEADE AVE STE 202
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714
Practice Address - Country:US
Practice Address - Phone:812-485-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000457A363L00000X, 363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000557880OtherANTHEM PIN
IN237890OtherMEDICARE GROUP
IN200859330JOtherMEDICAID GROUP
IN000000488130OtherANTHEM PIN
INDF3251OtherRAILROAD GROUP
IN200829650GOtherMEDICAID GROUP
INP00362819OtherRAILROAD INDIVIDUAL
IN000000311142OtherANTHEM PIN
IN200322860Medicaid
IN250470SOtherMEDICARE GROUP
KY78005964Medicaid
IN200322860Medicaid
IN000000557880OtherANTHEM PIN
IN000000488130OtherANTHEM PIN
IN200859330JOtherMEDICAID GROUP