Provider Demographics
NPI:1699826032
Name:ROACH, CAROL A (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:A
Last Name:ROACH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:ANN
Other - Last Name:ZATSICK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2234 PERKIOMEN AVE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-1830
Mailing Address - Country:US
Mailing Address - Phone:610-370-2511
Mailing Address - Fax:610-370-3266
Practice Address - Street 1:2234 PERKIOMEN AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-1830
Practice Address - Country:US
Practice Address - Phone:610-370-2511
Practice Address - Fax:610-370-3266
Is Sole Proprietor?:No
Enumeration Date:2007-01-14
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP006288B363LF0000X
PARN217659L363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P06518Medicare UPIN
037877Medicare PIN