Provider Demographics
NPI:1033494349
Name:ROZO-RIVERA, ASTRID (F-NP)
Entity Type:Individual
Prefix:MRS
First Name:ASTRID
Middle Name:
Last Name:ROZO-RIVERA
Suffix:
Gender:F
Credentials:F-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28415 PLANTATION DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-2966
Mailing Address - Country:US
Mailing Address - Phone:678-643-0313
Mailing Address - Fax:
Practice Address - Street 1:424 DECATUR ST SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1848
Practice Address - Country:US
Practice Address - Phone:678-843-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-18
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN210856363LF0000X
MI4704285879363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily