Latricia Cierra Rose, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2021186817 Issued in GA

Practice address

1423 Denison CT
Conyers, GA 30012-7133

Phone

(706) 615-7858

Fax

(770) 922-9366

NPI assigned

Mar 11, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Latricia Cierra Collins Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1801544689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 DENISON CT",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300127133",
            "telephone_number": "706-615-7858",
            "fax_number": "770-922-9366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 DENISON CT",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300127133",
            "telephone_number": "706-615-7858",
            "fax_number": "770-922-9366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "LATRICIA",
        "middle_name": "CIERRA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-11",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "2021186817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LATRICIA",
            "last_name": "COLLINS",
            "middle_name": "CIERRA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Beverly D. Roseberry, APRN
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• Juanita Ross, LMT
• Michelle A Ross, M.D.
• Royal Court of Esther Inc

• Family Nurse Practitioner in Conyers, GA
• Providers in Conyers, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.