MEDICARE: MRS. ROSSANA RADSPINNER RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN031398	AZ

General Provider Information

NPI Number	:	1609178821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROSSANA RADSPINNER RN

Provider Business Mailing Address
First Line	:	4311 E LINDEN ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-3240
Country	:	US
Telephone Number	:	520-232-8100
Fax Number	:	520-232-8101

Provider Business Practice Location Address
First Line	:	4311 E LINDEN ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-3240
Country	:	US
Telephone Number	:	520-232-8100
Fax Number	:	520-232-8101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2010
Last Update Date	:	11/19/2010

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