Healthcare Provider Details

I. General information

NPI: 1548856438
Provider Name (Legal Business Name): AMY CHRISTINE BUTALLA-ROSENE DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2020
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 N ROSEMONT BLVD STE 107
TUCSON AZ
85712-2137
US

IV. Provider business mailing address

4801 E BROADWAY BLVD STE 251
TUCSON AZ
85711-3633
US

V. Phone/Fax

Practice location:
  • Phone: 520-318-1033
  • Fax: 520-318-1338
Mailing address:
  • Phone: 520-327-0460
  • Fax: 520-795-0225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number188416
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number261742
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: