Provider Demographics
NPI:1174937379
Name:ROTZLER, GEORGINA (DNP PMHNP-BC)
Entity type:Individual
Prefix:
First Name:GEORGINA
Middle Name:
Last Name:ROTZLER
Suffix:
Gender:F
Credentials:DNP PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1384 E WALKER SPRINGS PL
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-6609
Mailing Address - Country:US
Mailing Address - Phone:518-538-4072
Mailing Address - Fax:404-337-8178
Practice Address - Street 1:1384 E WALKER SPRINGS PL
Practice Address - Street 2:
Practice Address - City:SAHUARITA
Practice Address - State:AZ
Practice Address - Zip Code:85629-6609
Practice Address - Country:US
Practice Address - Phone:518-538-4072
Practice Address - Fax:404-337-8178
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM02442363LP0808X
AZAP8174363LP0808X
NY40401710363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM47-5543790OtherEIN