Provider Demographics
NPI:1447356183
Name:ROLLAND, ROBERTA ANNE (RN, MS, FNP)
Entity type:Individual
Prefix:
First Name:ROBERTA
Middle Name:ANNE
Last Name:ROLLAND
Suffix:
Gender:F
Credentials:RN, MS, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 FIRELANE 17
Mailing Address - Street 2:
Mailing Address - City:CATO
Mailing Address - State:NY
Mailing Address - Zip Code:13033-3391
Mailing Address - Country:US
Mailing Address - Phone:315-246-0070
Mailing Address - Fax:
Practice Address - Street 1:1000 E GENESEE ST
Practice Address - Street 2:SUITE 300
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1892
Practice Address - Country:US
Practice Address - Phone:315-471-1044
Practice Address - Fax:315-474-4312
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334764363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily