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General NPI Number Information
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NPI Number | 1831183326
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Entity Type | Individual
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Provider Name | WARREN THOMAS ROSELAND JR. MSN, RN, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2225 NW STEWART PKWY STE 200
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City | ROSEBURG
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State | OR
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Zip | 97471-1650
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Country | US
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Telephone | 541-900-4285
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Fax |
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Provider Business Mailing Address
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Address Line | 4803 ELKRIDGE RD
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City | WEED
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State | CA
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Zip | 96094-9424
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Country | US
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Telephone | 209-769-6112
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Fax | 209-720-0139
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | RN 409980
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201811353
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP9245
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License Number State | CA
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