Provider Demographics
NPI:1447508361
Name:ROEPKE, MARY G (RN)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:G
Last Name:ROEPKE
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 1:12000 W EMIGH RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-9696
Mailing Address - Country:US
Mailing Address - Phone:520-616-6400
Mailing Address - Fax:520-616-6426
Practice Address - Street 1:12000 W EMIGH RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-9696
Practice Address - Country:US
Practice Address - Phone:520-616-6400
Practice Address - Fax:520-616-6426
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN158071390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program