Provider Demographics
NPI:1356140032
Name:ROSEBROUGH, ZOE BETH (MA, RD)
Entity type:Individual
Prefix:
First Name:ZOE
Middle Name:BETH
Last Name:ROSEBROUGH
Suffix:
Gender:
Credentials:MA, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 COTTONWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:PRYOR
Mailing Address - State:OK
Mailing Address - Zip Code:74361-9532
Mailing Address - Country:US
Mailing Address - Phone:918-803-6455
Mailing Address - Fax:
Practice Address - Street 1:40 COTTONWOOD CIR
Practice Address - Street 2:
Practice Address - City:PRYOR
Practice Address - State:OK
Practice Address - Zip Code:74361-9532
Practice Address - Country:US
Practice Address - Phone:918-803-6455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered