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General NPI Number Information
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NPI Number | 1982149225
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Entity Type | Individual
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Provider Name | JOHN ROSSON II APRN-CNP
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Gender | Male
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Dates
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Enumeration Date | 12/22/2016
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Last Update Date | 03/08/2019
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Provider Practice Location Address
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Address Line | 111 W FORREST AVE
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City | EUFAULA
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State | OK
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Zip | 74432-3205
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Country | US
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Telephone | 918-917-0762
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Fax |
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Provider Business Mailing Address
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Address Line | 111 W FORREST AVE STE A
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City | EUFAULA
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State | OK
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Zip | 74432-3205
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Country | US
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Telephone | 918-689-3333
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 86509
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 86509
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License Number State | OK
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