Provider Demographics
NPI:1588227771
Name:KANU, ROSSLYN
Entity Type:Individual
Prefix:
First Name:ROSSLYN
Middle Name:
Last Name:KANU
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 1:6819 COOK RD APT 1304
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-2251
Mailing Address - Country:US
Mailing Address - Phone:281-745-4335
Mailing Address - Fax:
Practice Address - Street 1:6819 COOK RD APT 1304
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-2251
Practice Address - Country:US
Practice Address - Phone:281-745-4335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX940712163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse