Provider Demographics
NPI:1912667296
Name:ROSEBROCK, JOSEPH ARNOLD (NP-C)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ARNOLD
Last Name:ROSEBROCK
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:DELPHOS
Mailing Address - State:OH
Mailing Address - Zip Code:45833-9180
Mailing Address - Country:US
Mailing Address - Phone:419-996-5030
Mailing Address - Fax:419-996-5458
Practice Address - Street 1:1800 E 5TH ST
Practice Address - Street 2:
Practice Address - City:DELPHOS
Practice Address - State:OH
Practice Address - Zip Code:45833-9180
Practice Address - Country:US
Practice Address - Phone:419-996-5030
Practice Address - Fax:419-996-5458
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031991363L00000X, 363LF0000X
CA95019207363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily