Healthcare Provider Details

I. General information

NPI: 1720954381
Provider Name (Legal Business Name): PAULETTE YVONNE ROZANKOWSKI FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 MONTCLAIRE AVE
FREDERICK MD
21701-4577
US

IV. Provider business mailing address

72 SMOKEBOX CIR
STEWARTSTOWN PA
17363-8780
US

V. Phone/Fax

Practice location:
  • Phone: 301-663-5252
  • Fax: 301-662-6943
Mailing address:
  • Phone: 301-663-5252
  • Fax: 301-662-6943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR195724
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: