Provider Demographics
NPI:1073293015
Name:ROSCHI, JENNA KIRSTEN (RN)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:KIRSTEN
Last Name:ROSCHI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:KIRSTEN
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:164 E CALLE TRONA
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-4470
Mailing Address - Country:US
Mailing Address - Phone:260-402-6676
Mailing Address - Fax:
Practice Address - Street 1:164 E CALLE TRONA
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-4470
Practice Address - Country:US
Practice Address - Phone:260-402-6676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN201946363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care