Provider Demographics
NPI:1750556916
Name:DEGUZMAN, MARYROSE (RN, FNP-C)
Entity type:Individual
Prefix:
First Name:MARYROSE
Middle Name:
Last Name:DEGUZMAN
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4821 N STONE AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-5727
Mailing Address - Country:US
Mailing Address - Phone:520-314-3300
Mailing Address - Fax:520-293-1957
Practice Address - Street 1:4821 N STONE AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-5727
Practice Address - Country:US
Practice Address - Phone:520-314-3300
Practice Address - Fax:520-293-1957
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF334858163WG0000X
AZAP4332363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice