Provider Demographics
NPI:1023861762
Name:ROLLMAN, TENA SHIZUMA (NNP)
Entity type:Individual
Prefix:
First Name:TENA
Middle Name:SHIZUMA
Last Name:ROLLMAN
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:TENA
Other - Middle Name:
Other - Last Name:SHIZUMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:835 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-4339
Mailing Address - Country:US
Mailing Address - Phone:702-327-0093
Mailing Address - Fax:
Practice Address - Street 1:2301 ERWIN RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4699
Practice Address - Country:US
Practice Address - Phone:919-681-5551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5020505363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care