Provider Demographics
NPI:1477707016
Name:ROSALES, BEVERLY ANN (MSN, CNOR, RNFA, FNP)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:ANN
Last Name:ROSALES
Suffix:
Gender:F
Credentials:MSN, CNOR, RNFA, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4647 E BUCKBOARD CT
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-5524
Mailing Address - Country:US
Mailing Address - Phone:480-212-2011
Mailing Address - Fax:480-279-9899
Practice Address - Street 1:4647 E BUCKBOARD CT
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-5524
Practice Address - Country:US
Practice Address - Phone:480-212-2011
Practice Address - Fax:480-279-9899
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN097766208600000X
AZAP8288363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily