Provider Demographics
NPI:1073086765
Name:ROSILEZ, ANGEL LYNN (FNP)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:LYNN
Last Name:ROSILEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36471 STRAIGHTAWAY DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-8147
Mailing Address - Country:US
Mailing Address - Phone:181-526-2510
Mailing Address - Fax:
Practice Address - Street 1:27710 JEFFERSON AVE STE 200
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-4604
Practice Address - Country:US
Practice Address - Phone:833-668-6676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-06
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95009899363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily