Provider Demographics
NPI:1760937460
Name:SCHAD, ROSEMARY (LPN)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:SCHAD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4407 N 55TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85031-1802
Mailing Address - Country:US
Mailing Address - Phone:623-691-4315
Mailing Address - Fax:623-691-4320
Practice Address - Street 1:4407 N 55TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031-1802
Practice Address - Country:US
Practice Address - Phone:623-691-4315
Practice Address - Fax:623-691-4320
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP050166164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse