Rosanna Denise Jaramillo
Individual provider Active NPI Athletic Trainer · Shady Dale, GA
NPI 1700533189 · NPPES record last updated Mar 7, 2022
Key facts
- NPI
- 1700533189
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 68 Whitten Rd
Shady Dale, GA 31085-3603 - Phone
- (478) 538-4973
- NPI assigned
- Mar 7, 2022
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
68 Whitten Rd
Shady Dale, GA 31085-3603
Mailing address
68 Whitten Rd
Shady Dale, GA 31085-3603
Phone (478) 538-4973
Other providers in Shady Dale, GA
All providers in Shady Dale, GA · Athletic Trainer in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.