Provider Demographics
NPI:1518424159
Name:ROLON, KATHERINE LYNN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:LYNN
Last Name:ROLON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:KATHERINE
Other - Middle Name:LYNN
Other - Last Name:CANNON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:106 S LOOP HWY 59
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:TX
Mailing Address - Zip Code:75551
Mailing Address - Country:US
Mailing Address - Phone:903-796-9355
Mailing Address - Fax:903-796-9360
Practice Address - Street 1:106 S LOOP HIGHWAY 59
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:TX
Practice Address - Zip Code:75551
Practice Address - Country:US
Practice Address - Phone:903-796-9355
Practice Address - Fax:903-796-9360
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-01
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137409363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily