Provider Demographics
NPI:1689470700
Name:ROZIER, KHAMAI MARION'DAY
Entity type:Individual
Prefix:
First Name:KHAMAI
Middle Name:MARION'DAY
Last Name:ROZIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 139
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37349-0139
Mailing Address - Country:US
Mailing Address - Phone:646-647-7611
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 139
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37349-0139
Practice Address - Country:US
Practice Address - Phone:646-647-7611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN171400000X, 172V00000X, 175F00000X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty
No172V00000XOther Service ProvidersCommunity Health Worker
No175F00000XOther Service ProvidersNaturopath