MEDICARE: MRS. ROSHUNDA STERLING RN

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
1	163W00000X	Registered Nurse	R872988	MS

General Provider Information

NPI Number	:	1760091888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROSHUNDA STERLING RN

Provider Business Mailing Address
First Line	:	421 HILLANDALE DR
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39212-3204
Country	:	US
Telephone Number	:	601-941-8199
Fax Number	:

Provider Business Practice Location Address
First Line	:	421 HILLANDALE DR
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39212-3204
Country	:	US
Telephone Number	:	601-941-8199
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2020
Last Update Date	:	07/24/2020

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