Provider Demographics
NPI:1588613442
Name:GARWOOD, ROSALYN MEDRICK (RN)
Entity Type:Individual
Prefix:MS
First Name:ROSALYN
Middle Name:MEDRICK
Last Name:GARWOOD
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 1:7034 N 55TH ST
Mailing Address - Street 2:APT G
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-6336
Mailing Address - Country:US
Mailing Address - Phone:414-531-3048
Mailing Address - Fax:
Practice Address - Street 1:7034 N 55TH ST
Practice Address - Street 2:APT G
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-6336
Practice Address - Country:US
Practice Address - Phone:414-531-3048
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39958100Medicaid