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NPI Code Detail

MEDICARE: KRISHA LASHA ROSSON

MEDICARE:   KRISHA LASHA ROSSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse767929TX

General Provider Information

NPI Number : 1619463783
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISHA LASHA ROSSON
Provider Business Mailing Address
First Line : 447 S BRYSON ST
Second Line :
City : BOGATA
State : TX
Zip : 75417-2614
Country : US
Telephone Number : 903-249-6151
Fax Number :
Provider Business Practice Location Address
First Line : 447 S BRYSON ST
Second Line :
City : BOGATA
State : TX
Zip : 75417-2614
Country : US
Telephone Number : 903-249-6151
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2018
Last Update Date : 07/02/2018

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Directions to “ KRISHA LASHA ROSSON ” Practice Location

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