Provider Demographics
NPI:1467695668
Name:ROSSMAN, SANDY DAVINA (MSN, ANP-BC)
Entity Type:Individual
Prefix:MS
First Name:SANDY
Middle Name:DAVINA
Last Name:ROSSMAN
Suffix:
Gender:F
Credentials:MSN, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1146 SAINT AUGUSTINE PL NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-4521
Mailing Address - Country:US
Mailing Address - Phone:404-892-6366
Mailing Address - Fax:
Practice Address - Street 1:1146 SAINT AUGUSTINE PL NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-4521
Practice Address - Country:US
Practice Address - Phone:404-892-6366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN078917363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health