Provider Demographics
NPI:1639279466
Name:ROLANDO, JOANN M (PHD, APRN-BC)
Entity Type:Individual
Prefix:MS
First Name:JOANN
Middle Name:M
Last Name:ROLANDO
Suffix:
Gender:F
Credentials:PHD, APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5777 WATERBURY CIR
Mailing Address - Street 2:UNIT L
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-1150
Mailing Address - Country:US
Mailing Address - Phone:801-910-9545
Mailing Address - Fax:801-584-2544
Practice Address - Street 1:GEORGE E WAHLEN DEPARTMENT OF VETERANS AFFAIRS
Practice Address - Street 2:MEDICAL CENTER VA
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84148-0001
Practice Address - Country:US
Practice Address - Phone:801-582-1565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT200413-4405363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health