Provider Demographics
NPI:1619463783
Name:ROSSON, KRISHA LASHA
Entity Type:Individual
Prefix:
First Name:KRISHA
Middle Name:LASHA
Last Name:ROSSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISHA
Other - Middle Name:LASHA ANN
Other - Last Name:ALLUMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:447 S BRYSON ST
Mailing Address - Street 2:
Mailing Address - City:BOGATA
Mailing Address - State:TX
Mailing Address - Zip Code:75417-2614
Mailing Address - Country:US
Mailing Address - Phone:903-249-6151
Mailing Address - Fax:
Practice Address - Street 1:447 S BRYSON ST
Practice Address - Street 2:
Practice Address - City:BOGATA
Practice Address - State:TX
Practice Address - Zip Code:75417-2614
Practice Address - Country:US
Practice Address - Phone:903-249-6151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX767929163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse