Provider Demographics
NPI:1841574803
Name:NOLAND, ROXSANNE MICHELLE
Entity Type:Individual
Prefix:MS
First Name:ROXSANNE
Middle Name:MICHELLE
Last Name:NOLAND
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 1:734 HABITAT
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-2577
Mailing Address - Country:US
Mailing Address - Phone:832-520-3803
Mailing Address - Fax:
Practice Address - Street 1:734 HABITAT
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2577
Practice Address - Country:US
Practice Address - Phone:832-520-3803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-07
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA00244156376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide