Individual
LORI KRISTEN ROSEBROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11700 N MERIDIAN ST, CARMEL, IN 46032-4656
(317) 944-7728
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10001280
IN
363A00000X
Physician Assistant
Primary
10001280A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300017025
—
IN
Enumeration date
06/29/2011
Last updated
06/24/2022
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