Individual provider Active NPI

Roseann Christine Poyourow, RN, BSN

  • Emergency Registered Nurse
  • Clarksville, TN
National Provider Identifier
1952575516
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Registered NurseTaxonomy code 163WE0003X
License
RN0000158642 Issued in TN
Practice address
1017 Harding Dr
Clarksville, TN 37042-3378
Phone
(706) 577-1561
NPI assigned
Apr 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X RN0000158642 TN Primary
Emergency Registered Nurse 163WE0003X RN179426 GA
Emergency Registered Nurse 163WE0003X 28158254A IN

Addresses

Primary practice location

1017 Harding Dr
Clarksville, TN 37042-3378

Mailing address

1017 Harding Dr
Clarksville, TN 37042-3378
Phone (706) 577-1561

Other names 1

  • Roseann Christine Czekala Former name

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN179426GAMDEmergency Registered Nurse
28158254AINMDEmergency Registered Nurse
RN0000158642TNMDEmergency Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208217600000",
    "number": "1952575516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 HARDING DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370423378",
            "telephone_number": "706-577-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 HARDING DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370423378",
            "telephone_number": "706-577-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POYOUROW",
        "first_name": "ROSEANN",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "TN",
            "license": "RN0000158642",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "GA",
            "license": "RN179426",
            "primary": false
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "IN",
            "license": "28158254A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSEANN",
            "last_name": "CZEKALA",
            "middle_name": "CHRISTINE",
            "credential": "RN, BSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.