Rosalyn Taylor Laster, RN. ES

Individual provider Active NPI Community Health Nurse Practitioner · Humboldt, TN

NPI 1639214869 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1639214869
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Nurse Practitioner 363LC1500X
License
APN0000011440 (TN)
Practice address
149 N 12TH Ave
Humboldt, TN 38343-2879
Phone
(731) 784-5491
Fax
(731) 784-1726
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
APN0000011440TNMDCommunity Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Nurse Practitioner 363LC1500X APN0000011440 TN Yes

Addresses

Primary practice location

149 N 12TH Ave
Humboldt, TN 38343-2879

Mailing address

149 N 12TH Ave
Humboldt, TN 38343-2879
Phone (731) 784-5491

Other providers in Humboldt, TN

All providers in Humboldt, TN · Community Health Nurse Practitioner in Tennessee

Sources for this page

Verify at the official NPI Registry.