Provider Demographics
NPI:1790402535
Name:ROZZI, JESSICA SHANNA (FNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:SHANNA
Last Name:ROZZI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:SHANNA
Other - Last Name:STAKOFKSY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:19 SLOOP SQ
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-3755
Mailing Address - Country:US
Mailing Address - Phone:908-692-6766
Mailing Address - Fax:
Practice Address - Street 1:19 SLOOP SQ
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-3755
Practice Address - Country:US
Practice Address - Phone:908-692-6766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01392500363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily