Provider Demographics
NPI:1386069789
Name:ROSENBERGER, SARAH ROSE (ACAGNP-BC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ROSE
Last Name:ROSENBERGER
Suffix:
Gender:F
Credentials:ACAGNP-BC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ROSE
Other - Last Name:ANDRYAUSKAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 64226
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4226
Mailing Address - Country:US
Mailing Address - Phone:667-214-1734
Mailing Address - Fax:410-328-0717
Practice Address - Street 1:419 W REDWOOD ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1734
Practice Address - Country:US
Practice Address - Phone:410-328-5840
Practice Address - Fax:410-328-0717
Is Sole Proprietor?:No
Enumeration Date:2014-02-22
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR187769363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care