Provider Demographics
NPI:1134370083
Name:COMER, ROSALYNN NADIA (ADULT NP-BC, ACNS-BC)
Entity type:Individual
Prefix:MRS
First Name:ROSALYNN
Middle Name:NADIA
Last Name:COMER
Suffix:
Gender:F
Credentials:ADULT NP-BC, ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 BARTRAM ST SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-6807
Mailing Address - Country:US
Mailing Address - Phone:770-361-6742
Mailing Address - Fax:
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2208
Practice Address - Country:US
Practice Address - Phone:404-686-7074
Practice Address - Fax:404-727-5405
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN166066363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health