Provider Demographics
NPI:1740445071
Name:ROLLE, ANNETTE M (CNA)
Entity type:Individual
Prefix:MISS
First Name:ANNETTE
Middle Name:M
Last Name:ROLLE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:MISS
Other - First Name:ANNETTE
Other - Middle Name:MARY
Other - Last Name:ROLLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12915 KNOTTY GLEN LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-3119
Mailing Address - Country:US
Mailing Address - Phone:832-888-7005
Mailing Address - Fax:281-568-0040
Practice Address - Street 1:12915 KNOTTY GLEN LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-3119
Practice Address - Country:US
Practice Address - Phone:832-888-7005
Practice Address - Fax:281-568-0400
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA08152727376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide