Healthcare Provider Details

I. General information

NPI: 1780727990
Provider Name (Legal Business Name): JUDITH FRANCK ROLLAR CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 03/03/2021
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4185 KIRKWOOD ST GEORGES RD
BEAR DE
19701-2272
US

IV. Provider business mailing address

1 GUTHRIE SQ
SAYRE PA
18840-1625
US

V. Phone/Fax

Practice location:
  • Phone: 302-834-7018
  • Fax: 302-836-2520
Mailing address:
  • Phone: 570-268-2239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0000315
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: