Provider Demographics
NPI:1639729700
Name:BATTAD, ROSANNA JOYCE MELO
Entity Type:Individual
Prefix:
First Name:ROSANNA JOYCE
Middle Name:MELO
Last Name:BATTAD
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 1:1506 WINTER PARK LN
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-2405
Mailing Address - Country:US
Mailing Address - Phone:972-522-9260
Mailing Address - Fax:
Practice Address - Street 1:3939 US HIGHWAY 80 E STE 458A
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-8109
Practice Address - Country:US
Practice Address - Phone:972-289-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143038363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner