Provider Demographics
NPI:1134203508
Name:ROSENBERG, LINDA (PA-C)
Entity type:Individual
Prefix:MISS
First Name:LINDA
Middle Name:
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8985 S PECOS RD
Mailing Address - Street 2:#4A
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7162
Mailing Address - Country:US
Mailing Address - Phone:702-433-1332
Mailing Address - Fax:702-547-4931
Practice Address - Street 1:8985 S PECOS RD
Practice Address - Street 2:#4A
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7162
Practice Address - Country:US
Practice Address - Phone:702-433-1332
Practice Address - Fax:702-547-4931
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA-C0129363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant