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Individual
TINA ROSENGRANT
Active
Individual
TINA ROSENGRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
SP015169
PA
363LX0106X
Occupational Health Nurse Practitioner
Primary
SP015169
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103424566
—
PA
Enumeration date
09/14/2015
Last updated
04/09/2021
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