Kelly Marice Roszak, PMHNP-BC - Nurse Practitioner in Burns, TN

Kelly Marice Roszak, PMHNP-BC is a Nurse Practitioner - Psychiatric/mental Health based in Burns, Tennessee. Kelly Marice Roszak is licensed to practice in Tennessee (license number 42264) and her current practice location is 1127 Old East Side Rd, Burns, Tennessee. She can be reached at her office (for appointments etc.) via phone at (216) 235-1084.

NPI number for Kelly Marice Roszak is 1992635510 and her current mailing address is 1127 Old East Side Rd, Burns, Tennessee. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1992635510.

Contact Information

Kelly Marice Roszak, PMHNP-BC
1127 Old East Side Rd,
Burns, TN 37029-5662
(216) 235-1084
Not Available

Map and Direction




Provider's Profile

Full NameKelly Marice Roszak
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location1127 Old East Side Rd, Burns, Tennessee
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1992635510
  • Provider Enumeration Date: 05/23/2026
  • Last Update Date: 06/29/2026

Medical Identifiers

Medical identifiers for Kelly Marice Roszak such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1992635510NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health 42264 (Tennessee)Primary
163W00000XRegistered Nurse 265015 (Tennessee)Secondary
363L00000XNurse Practitioner 42264 (Tennessee)Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Marice Roszak is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kelly Marice Roszak, PMHNP-BC
1127 Old East Side Rd,
Burns, TN 37029-5662

Ph: (216) 235-1084
Kelly Marice Roszak, PMHNP-BC
1127 Old East Side Rd,
Burns, TN 37029-5662

Ph: (216) 235-1084

Reviews and Comments


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Practice Location: 999 Girl Scout Rd, Burns, TN 37029
Phone: 615-703-6903    

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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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