Provider Demographics
NPI:1174925838
Name:ROSEL, FABIAN GLEN (PMHNP,PMHS,FNP)
Entity type:Individual
Prefix:
First Name:FABIAN
Middle Name:GLEN
Last Name:ROSEL
Suffix:
Gender:M
Credentials:PMHNP,PMHS,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-1933
Mailing Address - Country:US
Mailing Address - Phone:740-314-0010
Mailing Address - Fax:740-996-4199
Practice Address - Street 1:517 N 4TH ST
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-1933
Practice Address - Country:US
Practice Address - Phone:740-314-0010
Practice Address - Fax:740-996-4199
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.16408363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0111851Medicaid
WV3810028399Medicaid
WV3810028399Medicaid