Provider Demographics
NPI:1245774983
Name:ROSSMAN, JOANNA DELA CRUZ (C-AA)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:DELA CRUZ
Last Name:ROSSMAN
Suffix:
Gender:F
Credentials:C-AA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 IMPERATA ST NE APT 1425
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-8019
Mailing Address - Country:US
Mailing Address - Phone:832-527-3826
Mailing Address - Fax:
Practice Address - Street 1:2211 LOMAS BLVD NE # ACM200
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106
Practice Address - Country:US
Practice Address - Phone:505-272-2610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-15
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8220367H00000X
NMAA2018-002367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant