Basic Information
| Provider Information | |||||||||
| NPI: | 1629012166 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROSENFELD | ||||||||
| FirstName: | HILLARY | ||||||||
| MiddleName: | BROOKE | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 WASHINGTON AVE | ||||||||
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| City: | NEWPORT | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410711986 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592914800 | ||||||||
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| Practice Location | |||||||||
| Address1: | 565 RADIO HILL RD | ||||||||
| Address2: | |||||||||
| City: | MARION | ||||||||
| State: | VA | ||||||||
| PostalCode: | 243546587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2767821194 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 0001192901 | VA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.