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1336668730
PHILLISSA KAY ROZANSKY
BOISE, ID
NPI
1336668730
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Former Name
PHILLISSA KAY SIMPSON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LN0000X Nurse Practitioner Neonatal
(Licence: CO RN.0124082)
Enumeration Date
2017-09-17
Last Update Date
2018-06-16
Business Address
PHILLISSA KAY ROZANSKY
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 303-717-4168
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Mailing Address
PHILLISSA KAY ROZANSKY
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number:
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IDAHO ADVANCED MEDICAL CARE LLC