Provider Demographics
NPI:1336167931
Name:ROSETTE, JOYCE (NP)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:ROSETTE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S STONE AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85701-1912
Mailing Address - Country:US
Mailing Address - Phone:520-884-0707
Mailing Address - Fax:520-620-1598
Practice Address - Street 1:101 S STONE AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85701-1912
Practice Address - Country:US
Practice Address - Phone:520-884-0707
Practice Address - Fax:520-620-1598
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN0354432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ430083Medicaid
AZZ77327Medicare ID - Type Unspecified
AZ430083Medicaid