Healthcare Provider Details

I. General information

NPI: 1457224651
Provider Name (Legal Business Name): ROZELA ALMEDA JETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2025
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4959 WOLFCREEK VW
ATLANTA GA
30349-3954
US

IV. Provider business mailing address

4959 WOLFCREEK VW
ATLANTA GA
30349-3954
US

V. Phone/Fax

Practice location:
  • Phone: 706-332-2563
  • Fax:
Mailing address:
  • Phone: 706-332-2563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberRN272370
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: