Provider Demographics
NPI:1568073252
Name:EKPERI, ROSELYN ANGEL (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:ROSELYN
Middle Name:ANGEL
Last Name:EKPERI
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 SHENANDOAH DR
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-3247
Mailing Address - Country:US
Mailing Address - Phone:404-992-7920
Mailing Address - Fax:
Practice Address - Street 1:2258 NORTHLAKE PKWY
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4019
Practice Address - Country:US
Practice Address - Phone:770-670-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN234216363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics