Provider Demographics
NPI:1700533189
Name:JARAMILLO, ROSANNA DENISE
Entity Type:Individual
Prefix:MRS
First Name:ROSANNA
Middle Name:DENISE
Last Name:JARAMILLO
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 1:68 WHITTEN RD
Mailing Address - Street 2:
Mailing Address - City:SHADY DALE
Mailing Address - State:GA
Mailing Address - Zip Code:31085-3603
Mailing Address - Country:US
Mailing Address - Phone:478-538-4973
Mailing Address - Fax:
Practice Address - Street 1:68 WHITTEN RD
Practice Address - Street 2:
Practice Address - City:SHADY DALE
Practice Address - State:GA
Practice Address - Zip Code:31085-3603
Practice Address - Country:US
Practice Address - Phone:478-538-4973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer