Provider Demographics
NPI:1598047615
Name:ROESLER, RONDA SUE
Entity Type:Individual
Prefix:MRS
First Name:RONDA
Middle Name:SUE
Last Name:ROESLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MITCHELL ST
Mailing Address - Street 2:
Mailing Address - City:SINCLAIRVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14782
Mailing Address - Country:US
Mailing Address - Phone:716-748-9168
Mailing Address - Fax:
Practice Address - Street 1:220 FLUVANNA AVE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-2051
Practice Address - Country:US
Practice Address - Phone:716-487-1131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY541943-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health