Provider Demographics
NPI:1780209114
Name:MPOFU, ROSILYNE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ROSILYNE
Middle Name:
Last Name:MPOFU
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 1:5606 STEVENS CREEK BLVD APT 220
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-7605
Mailing Address - Country:US
Mailing Address - Phone:917-346-0095
Mailing Address - Fax:
Practice Address - Street 1:911 BRYANT ST
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2711
Practice Address - Country:US
Practice Address - Phone:650-327-0511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95014628363LP2300X
TXAP145703363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care