Provider Demographics
NPI:1528070984
Name:ROSSMAN, LINDA L (NP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:ROSSMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 WASHINGTON AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-1462
Mailing Address - Country:US
Mailing Address - Phone:616-842-6710
Mailing Address - Fax:616-842-1103
Practice Address - Street 1:700 WASHINGTON AVE STE 220
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-1462
Practice Address - Country:US
Practice Address - Phone:616-842-6710
Practice Address - Fax:616-842-1103
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704125249363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP00822032OtherRAILROAD MEDICARE
MIP00050329OtherRAILROAD MEDICARE
MIP32499Medicare UPIN
MIP00050329OtherRAILROAD MEDICARE
MIP41120043Medicare PIN