Provider Demographics
NPI:1588309785
Name:GARRETT, ROSALYN DENAYE (FNP)
Entity type:Individual
Prefix:
First Name:ROSALYN
Middle Name:DENAYE
Last Name:GARRETT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 APPLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-2513
Mailing Address - Country:US
Mailing Address - Phone:757-692-2787
Mailing Address - Fax:
Practice Address - Street 1:1540 BREEZEPORT WAY STE 100
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3752
Practice Address - Country:US
Practice Address - Phone:757-744-9044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024181406363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily