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General NPI Number Information
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NPI Number | 1306866892
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Entity Type | Individual
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Provider Name | ROSALYN HARRIETT PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 01/04/2013
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Provider Practice Location Address
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Address Line | 227 MAIN ST.
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City | DUNCAN
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State | AZ
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Zip | 85534
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Country | US
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Telephone | 928-359-1380
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Fax | 928-359-1381
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Provider Business Mailing Address
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Address Line | PO BOX 1625
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City | PAGE
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State | AZ
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Zip | 86040-1625
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Country | US
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Telephone | 928-645-9675
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Fax | 928-645-2626
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2817
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License Number State | AZ
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