Provider Demographics
NPI:1730786047
Name:ROSSER, MONIQUE AN-JEL (FNP)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:AN-JEL
Last Name:ROSSER
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 1:3060 ADDIE POND WAY SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-5326
Mailing Address - Country:US
Mailing Address - Phone:706-992-3955
Mailing Address - Fax:
Practice Address - Street 1:687 JOHNSON FERRY RD # 7044
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-4628
Practice Address - Country:US
Practice Address - Phone:770-977-9220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN216201363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily