Provider Demographics
NPI:1386857696
Name:FIGUEROA, ROSIE (NURSE LPN)
Entity type:Individual
Prefix:
First Name:ROSIE
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:F
Credentials:NURSE LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 134
Mailing Address - Street 2:18864 S COLLEGE ST.
Mailing Address - City:GADSDEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85336-0134
Mailing Address - Country:US
Mailing Address - Phone:928-920-4663
Mailing Address - Fax:928-627-9771
Practice Address - Street 1:1453 N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:SAN LUIS
Practice Address - State:AZ
Practice Address - Zip Code:85349
Practice Address - Country:US
Practice Address - Phone:928-627-6974
Practice Address - Fax:928-627-9771
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP008483390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ838196OtherAHCCCS