MRS. LISA MICHELE ROSBOROUGH NP NPI 1790928489

NPI Information

NPI: 1790928489
Provider Name: MRS. LISA MICHELE ROSBOROUGH, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
9900 BREN RD E
MINNETONKA, MN
ZIP 55343
Phone: (912) 663-3586
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MRS. Lisa Michele Rosborough, NP is a family nurse practitioner in Minnetonka, MN. MRS. Lisa Michele Rosborough, NP NPI is 1790928489. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

9900 BREN RD E
MINNETONKA, MN
ZIP 55343-664
Phone: (912) 663-3586

The NPI 1790928489 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/11/2009 and was last updated on 7/28/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	RN156565	GEORGIA	No
2	363LF0000X	Nurse Practitioner	Family	201350102NP	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	202I507764	OTHER	GEORGIA	MEDICARE
2	754611424A	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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