Provider Demographics
NPI:1790551471
Name:MONTALVO, ROSY STEPHANIE (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:ROSY
Middle Name:STEPHANIE
Last Name:MONTALVO
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82745 HORTA CT
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-1114
Mailing Address - Country:US
Mailing Address - Phone:760-333-5437
Mailing Address - Fax:
Practice Address - Street 1:82745 HORTA CT
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-1114
Practice Address - Country:US
Practice Address - Phone:760-333-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027846363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily