MEDICARE: JILANNE ROSE NP

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	RN131906	AZ
2	363LA2200X	Adult Health Nurse Practitioner	AP2134	AZ

General Provider Information

NPI Number	:	1912949041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILANNE ROSE NP

Provider Business Mailing Address
First Line	:	2155 E CONFERENCE DR
Second Line	:	STE 101
City	:	TEMPE
State	:	AZ
Zip	:	85284-2604
Country	:	US
Telephone Number	:	480-454-5562
Fax Number	:	480-868-2272

Provider Business Practice Location Address
First Line	:	2155 E CONFERENCE DR
Second Line	:	STE 101
City	:	TEMPE
State	:	AZ
Zip	:	85284-2604
Country	:	US
Telephone Number	:	480-454-5562
Fax Number	:	480-868-2272

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	02/12/2026

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Directions to “ JILANNE ROSE NP” Practice Location

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