Individual
MS. KELLY D ROSENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, NP
Contact information
Practice address
1221 E STATE ST, ROCKFORD, IL 61104-2231
(815) 972-1000
(815) 972-1086
Mailing address
1601 PARKVIEW AVE, CREDENTIALING S200, ROCKFORD, IL 61107-1822
(815) 395-5861
(815) 395-5575
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
209000443
IL
367A00000X
Advanced Practice Midwife
Primary
209008138
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209000443
STATE LICENSE
IL
Enumeration date
12/09/2005
Last updated
10/27/2023
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