Basic Information
| Provider Information | |||||||||
| NPI: | 1851585855 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROSENDO | ||||||||
| FirstName: | CHARITY | ||||||||
| MiddleName: | T. | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 61 N. NELLIS BLVD. | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023836240 | ||||||||
| FaxNumber: | 7024598586 | ||||||||
| Practice Location | |||||||||
| Address1: | 61 N. NELLIS BLVD. | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023836240 | ||||||||
| FaxNumber: | 7024598586 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2007 | ||||||||
| LastUpdateDate: | 10/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 819440 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LA2200X | 209-005932 | IL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LF0000X | 209-005932 | IL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 819440 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | APRN002759 | NV | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.