Basic Information
| Provider Information | |||||||||
| NPI: | 1831103977 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VELEZ | ||||||||
| FirstName: | ROSEANN | ||||||||
| MiddleName: | PATRICIA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 640 S. STATE STREET | ||||||||
| Address2: | MAIL CODE 3055 | ||||||||
| City: | DOVER | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199013530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3024801688 | ||||||||
| FaxNumber: | 3024809807 | ||||||||
| Practice Location | |||||||||
| Address1: | 22 S GREENE ST FL 11 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6672141616 | ||||||||
| FaxNumber: | 4103281674 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 01/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | LG-0011539 | DE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.