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Individual

JACQUELINE ROSEBORO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AGCNS-BC

Contact information

Practice address
10511 ATKINS RIDGE DR, CHARLOTTE, NC 28213-4296
(704) 473-6455
Mailing address
10511 ATKINS RIDGE DR, CHARLOTTE, NC 28213-4296
(704) 473-6455

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
185443
NC
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
2015005693
NC

Other

Enumeration date
10/21/2016
Last updated
11/20/2016
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