Provider Demographics
NPI:1265679880
Name:VANROOYEN, MARINDA (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARINDA
Middle Name:
Last Name:VANROOYEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3347 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-4115
Mailing Address - Country:US
Mailing Address - Phone:480-926-6301
Mailing Address - Fax:480-813-9011
Practice Address - Street 1:3347 E PARK AVE
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-4115
Practice Address - Country:US
Practice Address - Phone:480-926-6301
Practice Address - Fax:480-813-9011
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-20
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN115008163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool