Healthcare Provider Details

I. General information

NPI: 1992414403
Provider Name (Legal Business Name): ROSANNE WARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2022
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

948 N 1300 W
ST GEORGE UT
84770-4965
US

IV. Provider business mailing address

948 N 1300 W
ST GEORGE UT
84770-4965
US

V. Phone/Fax

Practice location:
  • Phone: 949-628-9310
  • Fax:
Mailing address:
  • Phone: 949-628-9310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberF22-102353
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: