Provider Demographics
NPI:1740296532
Name:ROSAS, JENNIFER JOY (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JOY
Last Name:ROSAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7500 N DREAMY DRAW DR STE 145
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4668
Mailing Address - Country:US
Mailing Address - Phone:480-882-4545
Mailing Address - Fax:480-882-5814
Practice Address - Street 1:16251 N CAVE CREEK RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2976
Practice Address - Country:US
Practice Address - Phone:480-882-4545
Practice Address - Fax:480-882-5814
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2006037232207Q00000X
AZ48965207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ899492Medicaid