Provider Demographics
NPI:1831223593
Name:ROSANDER, SHELLEY A (NP, WHCP)
Entity type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:A
Last Name:ROSANDER
Suffix:
Gender:F
Credentials:NP, WHCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:973 FEATHERSTONE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-5912
Mailing Address - Country:US
Mailing Address - Phone:815-986-3737
Mailing Address - Fax:815-986-3748
Practice Address - Street 1:973 FEATHERSTONE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-5912
Practice Address - Country:US
Practice Address - Phone:815-986-3737
Practice Address - Fax:815-986-3748
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health