Provider Demographics
NPI:1558061044
Name:MAGLANOC, ROSELYN AGULTO (FNP)
Entity Type:Individual
Prefix:
First Name:ROSELYN
Middle Name:AGULTO
Last Name:MAGLANOC
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 1:23033 E ORCHARD LN
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-2151
Mailing Address - Country:US
Mailing Address - Phone:443-562-9387
Mailing Address - Fax:
Practice Address - Street 1:23033 E ORCHARD LN
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-2151
Practice Address - Country:US
Practice Address - Phone:443-562-9387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZF03230042363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily