Provider Demographics
NPI:1598151151
Name:ROLLS, KERI MICHELE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:KERI
Middle Name:MICHELE
Last Name:ROLLS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 APPLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-2104
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:330 S SERVICE RD STE 121
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-3253
Practice Address - Country:US
Practice Address - Phone:516-876-4100
Practice Address - Fax:516-876-4101
Is Sole Proprietor?:No
Enumeration Date:2015-04-10
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF339367-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily