Provider Demographics
NPI:1811269426
Name:ROLLAND, KATHY REGINA
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:REGINA
Last Name:ROLLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9970 ARBORWOOD DRIVE
Mailing Address - Street 2:212
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-1546
Mailing Address - Country:US
Mailing Address - Phone:513-418-3827
Mailing Address - Fax:
Practice Address - Street 1:9970 ARBORWOOD DR
Practice Address - Street 2:212
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251-1570
Practice Address - Country:US
Practice Address - Phone:513-418-3827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 129101 M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse