Provider Demographics
NPI:1588014229
Name:DUKETTE, ROZELLE JASMINE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ROZELLE
Middle Name:JASMINE
Last Name:DUKETTE
Suffix:
Gender:F
Credentials:FNP-BC
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3400 BAINBRIDGE AVE
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2404
Mailing Address - Country:US
Mailing Address - Phone:718-920-2626
Mailing Address - Fax:718-652-1833
Practice Address - Street 1:3400 BAINBRIDGE AVE
Practice Address - Street 2:7TH FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2404
Practice Address - Country:US
Practice Address - Phone:718-920-2626
Practice Address - Fax:718-652-1833
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY339448363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04556290Medicaid