Provider Demographics
NPI:1548433246
Name:ROZELLE, GRETCHEN ANN (RN)
Entity type:Individual
Prefix:MS
First Name:GRETCHEN
Middle Name:ANN
Last Name:ROZELLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 E VAN BUREN ST
Mailing Address - Street 2:BLDG F REHABILITATION
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-6037
Mailing Address - Country:US
Mailing Address - Phone:602-220-6048
Mailing Address - Fax:602-629-7335
Practice Address - Street 1:2500 E VAN BUREN ST
Practice Address - Street 2:BLDG F REHABILITATION
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-6037
Practice Address - Country:US
Practice Address - Phone:602-220-6048
Practice Address - Fax:602-629-7335
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN066258163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZRN066258OtherARIZONA REGISTERED NURSE