Provider Demographics
NPI:1720089238
Name:KLINEPETER, ROSALIND C (CNM)
Entity Type:Individual
Prefix:
First Name:ROSALIND
Middle Name:C
Last Name:KLINEPETER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:386 STRAWBERRY LN
Mailing Address - Street 2:
Mailing Address - City:BIG COVE TANNERY
Mailing Address - State:PA
Mailing Address - Zip Code:17212-9425
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:386 STRAWBERRY LN
Practice Address - Street 2:
Practice Address - City:BIG COVE TANNERY
Practice Address - State:PA
Practice Address - Zip Code:17212-9425
Practice Address - Country:US
Practice Address - Phone:717-816-6914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN176944L163W00000X
PAMW008573L176B00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA867633OtherGROUP MEDICARE #
PA001799570 0003Medicaid
PA25-1716306OtherHEALTHNET/TRICARE
PA50010206OtherCAPITAL BLUECROSS (POTOMAC)
PAMW008573LOtherLICENSE
PA148683OtherHIGHMARK BLUE SHIELD
PA1720089238OtherFIRST HEALTH
PA384256OtherHEALTH AMERICA
PA50087600OtherCAPITAL BLUECROSS (COUNTRY CARE)
PA138126OtherUNISON (POTOMAC)
PA25-1716306OtherINTERGROUP
PA25-1716306OtherMULTIPLAN/PHCS
PA420001728OtherRAILROAD MEDICARE
PA6883355OtherAETNA HMO (POTOMAC)
PA25-1716306OtherINFORMED
PA867633OtherMEDICARE GROUP #
PA9278320OtherAETNA NON-HMO (POTOMAC)
PAS54700001/D8NOCOOtherCAREFIRST (COUNTRY CARE)
PA6883355OtherAETNA HMO (POTOMAC)
PAP06406Medicare UPIN