Provider Demographics
NPI:1154593903
Name:ROUNDY, JOSEPHINE R (RN,)
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:R
Last Name:ROUNDY
Suffix:
Gender:F
Credentials:RN,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 EAST GARDEN AVE
Mailing Address - Street 2:P O BOX 715
Mailing Address - City:COLORADO CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86021-0715
Mailing Address - Country:US
Mailing Address - Phone:435-467-5012
Mailing Address - Fax:
Practice Address - Street 1:50 EAST GARDEN AVE.
Practice Address - Street 2:
Practice Address - City:COLORADO CITY
Practice Address - State:AZ
Practice Address - Zip Code:86021-0715
Practice Address - Country:US
Practice Address - Phone:435-467-5012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN092607163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health