Provider Demographics
NPI:1831838515
Name:ROLLE, DONNA ROSE (RN, BSN, IBCLC)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:ROSE
Last Name:ROLLE
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 WESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405-2755
Mailing Address - Country:US
Mailing Address - Phone:540-623-4900
Mailing Address - Fax:
Practice Address - Street 1:1207 WESTVIEW DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405-2755
Practice Address - Country:US
Practice Address - Phone:540-623-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAL86974163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant