Provider Demographics
NPI:1164498382
Name:ROLAND, KRISTI H (DPT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:H
Last Name:ROLAND
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:KRISTI
Other - Middle Name:A
Other - Last Name:HOLANCIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:114 CAPTAINS CIR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-6732
Mailing Address - Country:US
Mailing Address - Phone:615-859-0351
Mailing Address - Fax:615-859-0354
Practice Address - Street 1:2021 GALLATIN PIKE N
Practice Address - Street 2:SUITE 248
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-2097
Practice Address - Country:US
Practice Address - Phone:615-859-0351
Practice Address - Fax:615-859-0354
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT73822251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3646335Medicaid
TN3646335Medicaid