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General NPI Number Information
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NPI Number | 1194556209
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Entity Type | Individual
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Provider Name | KRYSTAL ROSETTE NP
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Gender | Female
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Dates
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Enumeration Date | 08/10/2024
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 3201 S CARROLLTON AVE
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City | NEW ORLEANS
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State | LA
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Zip | 70118-4307
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Country | US
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Telephone | 504-207-3060
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 231121
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City | NEW ORLEANS
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State | LA
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Zip | 70183-1121
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Country | US
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Telephone | 337-308-4005
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 240120
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License Number State | LA
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