Active NPI
Desiree Nzouango Rosant, NP
- Family Nurse Practitioner
- Minnetonka, MN
National Provider Identifier
1679094494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 125321
- Practice address
- 9900 Bren Rd E
Minnetonka, MN 55343-9664 - Phone
- (855) 247-8474
- NPI assigned
- Jul 1, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 125321 | GA | Primary |
Addresses
Primary practice location
9900 Bren Rd E
Minnetonka, MN 55343-9664
Mailing address
PO Box 1459
Minneapolis, MN 55440-1459
Other practice location 1
1300 Tiger Blvd
Clemson, SC 29631-1114
Phone (401) 770-1731
Other practice location 2
2429 Martin Luther King Jr Dr SW
Atlanta, GA 30311-1713
Phone (404) 961-9580
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125321 | GA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605657600000",
"number": "1679094494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1459",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554401459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9900 BREN RD E",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553439664",
"telephone_number": "855-247-8474"
}
],
"practiceLocations": [
{
"address_1": "1300 Tiger Blvd",
"address_purpose": "LOCATION",
"city": "Clemson",
"state": "SC",
"postal_code": "296311114",
"country_code": "US",
"telephone_number": "401-770-1731",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2429 Martin Luther King Jr Dr SW",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303111713",
"country_code": "US",
"telephone_number": "404-961-9580",
"fax_number": "404-691-7205",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROSANT",
"first_name": "DESIREE",
"middle_name": "NZOUANGO",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-01",
"last_updated": "2020-11-18",
"certification_date": "2020-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "125321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.