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General NPI Number Information
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NPI Number | 1588309785
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Entity Type | Individual
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Provider Name | ROSALYN DENAYE GARRETT FNP
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Gender | Female
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Dates
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Enumeration Date | 05/02/2022
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Last Update Date | 05/02/2022
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Provider Practice Location Address
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Address Line | 1540 BREEZEPORT WAY STE 100
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City | SUFFOLK
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State | VA
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Zip | 23435-3752
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Country | US
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Telephone | 757-744-9044
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Fax |
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Provider Business Mailing Address
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Address Line | 305 APPLEWOOD CT
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City | SUFFOLK
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State | VA
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Zip | 23434-2513
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Country | US
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Telephone | 757-692-2787
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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 | 0024181406
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License Number State | VA
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