Healthcare Provider Details

I. General information

NPI: 1073643284
Provider Name (Legal Business Name): ROSALIND LILLY R.N., N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44900 60TH ST W
LANCASTER CA
93536-7618
US

IV. Provider business mailing address

44900 60TH ST W
LANCASTER CA
93536-7618
US

V. Phone/Fax

Practice location:
  • Phone: 661-948-8581
  • Fax: 991-945-8474
Mailing address:
  • Phone: 661-948-8581
  • Fax: 991-945-8474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN375426
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP8432
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: