Provider Demographics
NPI:1245093921
Name:AUDE, ROXANNE L
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:L
Last Name:AUDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAMANCHE
Mailing Address - State:IA
Mailing Address - Zip Code:52730-1772
Mailing Address - Country:US
Mailing Address - Phone:563-259-3000
Mailing Address - Fax:563-259-3005
Practice Address - Street 1:702 13TH AVE
Practice Address - Street 2:
Practice Address - City:CAMANCHE
Practice Address - State:IA
Practice Address - Zip Code:52730-1772
Practice Address - Country:US
Practice Address - Phone:563-259-3000
Practice Address - Fax:563-259-3005
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion