Active NPI
Shyanne Roznowski, NP
- Psychiatric/Mental Health Nurse Practitioner
- Fort Benning, GA
National Provider Identifier
1083187231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 59659
- Practice address
- 6600 Van Aalst Blvd
Fort Benning, GA 31905-2102 - Phone
- (762) 408-2605
- NPI assigned
- Jan 9, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 51805 | ID | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 59659 | ID | Primary |
Addresses
Primary practice location
6600 Van Aalst Blvd
Fort Benning, GA 31905-2102
Mailing address
6600 Van Aalst Blvd
Fort Moore, GA 31905-2102
Phone (208) 407-0175
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51805 | ID | MD | Registered Nurse |
| 59659 | ID | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737676800000",
"number": "1083187231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6600 VAN AALST BLVD",
"city": "FORT MOORE",
"state": "GA",
"postal_code": "319052102",
"telephone_number": "208-407-0175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6600 VAN AALST BLVD",
"city": "FORT BENNING",
"state": "GA",
"postal_code": "319052102",
"telephone_number": "762-408-2605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROZNOWSKI",
"first_name": "SHYANNE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-09",
"last_updated": "2025-01-24",
"certification_date": "2025-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "ID",
"license": "51805",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "ID",
"license": "59659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Benning, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.