Provider Demographics
NPI:1053377572
Name:KING, ROSEMARY R (APRN,BC)
Entity type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:R
Last Name:KING
Suffix:
Gender:F
Credentials:APRN,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1299
Mailing Address - Street 2:215 W. SILVER SKY PLACE
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85622-1299
Mailing Address - Country:US
Mailing Address - Phone:520-400-3456
Mailing Address - Fax:520-648-0349
Practice Address - Street 1:3003 N CENTRAL AVE STE 800
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2946
Practice Address - Country:US
Practice Address - Phone:602-345-2554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN-027421363LX0106X
AZRN027421363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health