Provider Demographics
NPI:1013687086
Name:PRINGLE, ROSALIE S R (RN)
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:S R
Last Name:PRINGLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 MARTIN LUTHER KING JR DR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-3674
Mailing Address - Country:US
Mailing Address - Phone:404-613-6382
Mailing Address - Fax:
Practice Address - Street 1:3700 MARTIN LUTHER KING JR DR SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-3674
Practice Address - Country:US
Practice Address - Phone:404-613-6382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN260563163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse