Provider Demographics
NPI:1598457996
Name:JOSEPH, ROSETTE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ROSETTE
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 GALLOWS RD STE D
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3962
Mailing Address - Country:US
Mailing Address - Phone:571-462-6829
Mailing Address - Fax:
Practice Address - Street 1:523 ROCKINGHAM RD
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-3615
Practice Address - Country:US
Practice Address - Phone:910-562-9882
Practice Address - Fax:910-562-9955
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5018144363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health