Provider Demographics
NPI:1831466861
Name:ROZOF, NICOLE DEANGELO (FNP)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:DEANGELO
Last Name:ROZOF
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6514 MEADOW RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6115
Mailing Address - Country:US
Mailing Address - Phone:443-844-1540
Mailing Address - Fax:
Practice Address - Street 1:6514 MEADOW RIDGE RD
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6115
Practice Address - Country:US
Practice Address - Phone:443-844-1540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-18
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC249166163W00000X
NC5005400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse