Provider Demographics
NPI:1871013573
Name:THARP, ROSLYNN (RN)
Entity Type:Individual
Prefix:
First Name:ROSLYNN
Middle Name:
Last Name:THARP
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 1:6184 SUMMERVILLE DR
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061-4334
Mailing Address - Country:US
Mailing Address - Phone:804-815-6376
Mailing Address - Fax:
Practice Address - Street 1:6184 SUMMERVILLE DR
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:VA
Practice Address - Zip Code:23061-4334
Practice Address - Country:US
Practice Address - Phone:804-815-6376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001131224163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse