Healthcare Provider Details

I. General information

NPI: 1083594014
Provider Name (Legal Business Name): CAYLEN VIRGINIA ROACH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2025
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7255 E SNYDER RD UNIT 2101
TUCSON AZ
85750-6241
US

IV. Provider business mailing address

7255 E SNYDER RD UNIT 2101
TUCSON AZ
85750-6241
US

V. Phone/Fax

Practice location:
  • Phone: 520-225-9972
  • Fax:
Mailing address:
  • Phone: 520-225-9972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number325963
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: