Doctor Name: | TIFFANY ROLLER |
NPI Number: | 1952705329 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 043.109673 |
Business Practice Address: | 607 Buchanan St Carthage, IL - 623211401 |
Business Phone Number: | 2173573176 |
Business Fax Number: | 2173576609 |
Mailing Address: | 700 Se Cross St, MOUNT STERLING |
State: | IL |
Postal Code: | 623531561 |
Phone Number: | 2177733325 |
Fax Number: | 2177732425 |
NPI Enumeration Date: | 10/14/2014 |
NPI Last Update Date: | 10/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 164W00000X |
License Number: | 043.109673 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Practical Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |