Provider Demographics
NPI:1588195549
Name:BRANSON, ROSZA
Entity Type:Individual
Prefix:
First Name:ROSZA
Middle Name:
Last Name:BRANSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 LAUREL BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:37763-6022
Mailing Address - Country:US
Mailing Address - Phone:865-742-4935
Mailing Address - Fax:
Practice Address - Street 1:1202 LAUREL BLUFF RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:TN
Practice Address - Zip Code:37763-6022
Practice Address - Country:US
Practice Address - Phone:865-742-4935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN188794163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health