Healthcare Provider Details

I. General information

NPI: 1225099468
Provider Name (Legal Business Name): ROSLYN DUNNING CRNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3110 N LLOYD BUSH DR
TUCSON AZ
85745-9071
US

IV. Provider business mailing address

PO BOX 85520
TUCSON AZ
85754-5520
US

V. Phone/Fax

Practice location:
  • Phone: 520-777-4470
  • Fax: 520-777-4470
Mailing address:
  • Phone: 520-777-4470
  • Fax: 520-777-4470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN - 04084
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: