Basic Information
Provider Information
NPI: 1437773702
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROSSCUP
FirstName: APRIL
MiddleName: JEAN
NamePrefix: MRS.
NameSuffix:  
Credential: MSN, APRN, FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 33269
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850673269
CountryCode: US
TelephoneNumber: 6024064786
FaxNumber: 9166364358
Practice Location
Address1: 350 W THOMAS RD
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850134409
CountryCode: US
TelephoneNumber: 6024068302
FaxNumber: 6024067247
Other Information
ProviderEnumerationDate: 06/02/2020
LastUpdateDate: 04/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/02/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X241795AZY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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