Individual
MR. WARREN THOMAS ROSELAND JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, RN, FNP-C
Contact information
Practice address
2225 NW STEWART PKWY STE 200, ROSEBURG, OR 97471-1650
(541) 900-4285
Mailing address
4803 ELKRIDGE RD, WEED, CA 96094-9424
(209) 769-6112
(209) 720-0139
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
RN 409980
CA
363LF0000X
Family Nurse Practitioner
201811353
OR
363LF0000X
Family Nurse Practitioner
Primary
NP9245
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201811353NP-PP
OREGON FNP LICENS
OR
01
—
201811353RN
OREGON RN LICENSE
OR
05
—
500759209
—
OR
01
—
NP 9245
BRN-CALIF FNP LICENSE
CA
01
—
NP9245
CA FNP LICENSE
CA
01
—
RN049980
CA RN LICENSE
CA
Enumeration date
09/12/2005
Last updated
03/07/2023
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