Provider Demographics
NPI:1255592549
Name:ROSKOS, AMY THOMAS (APN)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:THOMAS
Last Name:ROSKOS
Suffix:
Gender:F
Credentials:APN
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Mailing Address - Street 1:6077 PRIMACY PKWY STE 140
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-5754
Mailing Address - Country:US
Mailing Address - Phone:901-259-1673
Mailing Address - Fax:901-259-7637
Practice Address - Street 1:2100 EXETER RD STE 200
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3966
Practice Address - Country:US
Practice Address - Phone:901-641-3000
Practice Address - Fax:901-701-2460
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2023-03-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN13500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN13500OtherSTATE LICENSE