Tracy Roseberry
Nurse Practitioner - Women's Health
5003 Hardy St Suite 350
Hattiesburg
, Mississippi 39402-1319
Tracy Roseberry
Nurse Practitioner - Women's Health
5003 Hardy St Suite 350
Hattiesburg
, Mississippi 39402-1319
(601) 268-9393
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About
Features
Specialties
- Nurse Practitioner - Women's Health
Languages spoken
- English
Location
First Address
- Tracy Roseberry
- 6524 U S Highway 98
- Hattiesburg, MS
- Zip : 39402-8569
- Fax : (601) 268-9393
- Phone : (601) 268-9393
Second Address
- Tracy Roseberry
- 5003 Hardy St Suite 350
- Hattiesburg, MS
- Zip : 39402-1319
- Fax : (601) 268-9393
- Phone : (601) 268-9393
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LW0102X | Nurse Practitioner - Women's Health | R717789 | MS |
National Provider Identifier
| NPI | 1083691489 |
|---|---|
| Provider Name | Tracy Roseberry |
| First Address | Hattiesburg, MS 39402-8569 |
| Second Address | Hattiesburg, MS 39402-1319 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/12/2005 |
| Last Update Date | 30/10/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00118112 | (05) | MS |
| S39158 | (02) | MS |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.