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General NPI Number Information
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NPI Number | 1225878457
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Entity Type | Individual
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Provider Name | ROSHNEY THOMAS PUTHANKALAM PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/27/2024
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 1503 PROFESSIONAL CT
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City | DALTON
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State | GA
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Zip | 30720-2566
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Country | US
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Telephone | 706-281-8490
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Fax | 706-529-8487
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Provider Business Mailing Address
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Address Line | 1503 PROFESSIONAL CT
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City | DALTON
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State | GA
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Zip | 30720-2566
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Country | US
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Telephone | 706-281-8490
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Fax | 706-529-8487
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 35848
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | GAA-NP004346
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License Number State | GA
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