Healthcare Provider Details

I. General information

NPI: 1306902788
Provider Name (Legal Business Name): CAROLYN ROSE TAPAHE R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4212 N 16TH ST
PHOENIX AZ
85016-5319
US

IV. Provider business mailing address

10,005 EAST OSBORN
SCOTTSDALE AZ
85256
US

V. Phone/Fax

Practice location:
  • Phone: 602-263-1511
  • Fax: 602-263-1619
Mailing address:
  • Phone: 480-946-9066
  • Fax: 480-946-9415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN101260
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: