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NPI Code Detail

MEDICARE: MRS. JACQUELINE NATASHA ROZMAN NP-C

MEDICARE: MRS. JACQUELINE NATASHA ROZMAN NP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerRN200773GA

General Provider Information

NPI Number : 1174912539
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JACQUELINE NATASHA ROZMAN NP-C
Provider Business Mailing Address
First Line : 3008 E PARK AVE
Second Line :
City : BRUNSWICK
State : GA
Zip : 31520-4241
Country : US
Telephone Number : 912-265-2142
Fax Number : 912-265-0530
Provider Business Practice Location Address
First Line : 3008 E PARK AVE
Second Line :
City : BRUNSWICK
State : GA
Zip : 31520-4241
Country : US
Telephone Number : 912-265-2142
Fax Number : 912-265-0530
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2015
Last Update Date : 01/22/2015

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Directions to “ MRS. JACQUELINE NATASHA ROZMAN NP-C” Practice Location

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