Provider Demographics
NPI:1891054011
Name:KASSELMANN, ROXANNE (RN)
Entity Type:Individual
Prefix:MS
First Name:ROXANNE
Middle Name:
Last Name:KASSELMANN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ROXANNE
Other - Middle Name:
Other - Last Name:VENZUCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3300 PARKSIDE DR APT 2
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-2540
Mailing Address - Country:US
Mailing Address - Phone:406-461-2207
Mailing Address - Fax:
Practice Address - Street 1:1501 CAPITOL AVE # MS 4502
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-5005
Practice Address - Country:US
Practice Address - Phone:916-558-1805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA573562163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health