Provider Demographics
NPI:1922032192
Name:ROLLETTE, DENISE DAWN (DC)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:DAWN
Last Name:ROLLETTE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 RUE SIMONE
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-5728
Mailing Address - Country:US
Mailing Address - Phone:985-345-9504
Mailing Address - Fax:985-345-9546
Practice Address - Street 1:2108 RUE SIMONE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-5728
Practice Address - Country:US
Practice Address - Phone:985-345-9504
Practice Address - Fax:985-345-9546
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA668111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2280AOtherBC BS OFFICE
LAP00246844OtherRAILROAD MEDICARE
LA3119AOtherBLUECROSS BLUESHIELD
LA4290964OtherAETNA OFFICE
LADD7261OtherRAILROAD MEDICARE OFFICE
LA2280AOtherBC BS OFFICE
LAP00246844OtherRAILROAD MEDICARE
LAU20490Medicare UPIN