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General NPI Number Information
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NPI Number | 1578968053
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Entity Type | Individual
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Provider Name | LORI ROSCOE APRN
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Gender | Female
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Dates
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Enumeration Date | 10/27/2014
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 1388 KETTNER BLVD UNIT 702
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City | SAN DIEGO
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State | CA
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Zip | 92101-2774
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Country | US
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Telephone | 404-805-9502
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Fax |
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Provider Business Mailing Address
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Address Line | 1388 KETTNER BLVD UNIT 702
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City | SAN DIEGO
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State | CA
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Zip | 92101-2774
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Country | US
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Telephone | 404-805-9502
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN9485060
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN179490
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | NP95006810
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License Number State | CA
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