Provider Demographics
NPI:1003308156
Name:JONSON, ROSALIND ROCHELLE
Entity Type:Individual
Prefix:
First Name:ROSALIND
Middle Name:ROCHELLE
Last Name:JONSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CITYPLACE DR STE 224
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7390
Mailing Address - Country:US
Mailing Address - Phone:314-221-9168
Mailing Address - Fax:
Practice Address - Street 1:2 CITYPLACE DR STE 224
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7390
Practice Address - Country:US
Practice Address - Phone:314-221-9168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty