=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912825258
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROZLYN WAKEFIELD CRNA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/06/2026
-----------------------------------------------------
Last Update Date | 07/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 600 GRESHAM DR
-----------------------------------------------------
City | NORFOLK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23507-1904
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-388-3000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 408 WASHINGTON ST
-----------------------------------------------------
City | PORTSMOUTH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23704-2435
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 952-491-1711
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367500000X
-----------------------------------------------------
Taxonomy Name | Certified Registered Nurse Anesthetist
-----------------------------------------------------
License Number | 0024197866
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------