Provider Demographics
NPI:1588232268
Name:PYLE, ROSALYN HELENE (RN, PHN)
Entity Type:Individual
Prefix:MRS
First Name:ROSALYN
Middle Name:HELENE
Last Name:PYLE
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:MISS
Other - First Name:ROSALYN
Other - Middle Name:HELENE
Other - Last Name:BOOTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 5
Mailing Address - Street 2:
Mailing Address - City:MARIPOSA
Mailing Address - State:CA
Mailing Address - Zip Code:95338-0005
Mailing Address - Country:US
Mailing Address - Phone:209-966-3689
Mailing Address - Fax:209-966-4929
Practice Address - Street 1:5300 HWY 49
Practice Address - Street 2:
Practice Address - City:MARIPOSA
Practice Address - State:CA
Practice Address - Zip Code:95338-9533
Practice Address - Country:US
Practice Address - Phone:209-966-3689
Practice Address - Fax:209-966-3689
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95125920163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse