Healthcare Provider Details

I. General information

NPI: 1780858159
Provider Name (Legal Business Name): ROSLYN MARIE SEITZ MSN, APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 11/02/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 MEDICAL CENTER BLVD
LAWRENCEVILLE GA
30045-7694
US

IV. Provider business mailing address

2570 48TH ST
SACRAMENTO CA
95817-1541
US

V. Phone/Fax

Practice location:
  • Phone: 678-442-3317
  • Fax:
Mailing address:
  • Phone: 916-734-2145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN185556 NP
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: