Provider Demographics
NPI:1053637819
Name:OLIPHANT, ROSIE (ASSOC NURSING)
Entity Type:Individual
Prefix:MRS
First Name:ROSIE
Middle Name:
Last Name:OLIPHANT
Suffix:
Gender:F
Credentials:ASSOC NURSING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 W FRYE RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-6178
Mailing Address - Country:US
Mailing Address - Phone:480-224-2102
Mailing Address - Fax:
Practice Address - Street 1:1525 W FRYE RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6178
Practice Address - Country:US
Practice Address - Phone:480-224-2102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN152866163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool