Provider Demographics
NPI:1740528033
Name:ROZWOOD, JESSICA MICHELE (LPN)
Entity type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:MICHELE
Last Name:ROZWOOD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4618 OAK ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:NY
Mailing Address - Zip Code:14411-9435
Mailing Address - Country:US
Mailing Address - Phone:585-589-0576
Mailing Address - Fax:585-589-7845
Practice Address - Street 1:4618 OAK ORCHARD RD
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:NY
Practice Address - Zip Code:14411-9435
Practice Address - Country:US
Practice Address - Phone:585-589-0576
Practice Address - Fax:585-589-7845
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY312721-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse