Healthcare Provider Details

I. General information

NPI: 1386784726
Provider Name (Legal Business Name): CARLA LYNN ROSLER CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 03/02/2021
Certification Date: 03/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 PUTNAM ST
MARIETTA OH
45750-2923
US

IV. Provider business mailing address

PO BOX 724
ATHENS OH
45701-0724
US

V. Phone/Fax

Practice location:
  • Phone: 740-374-6989
  • Fax:
Mailing address:
  • Phone: 740-592-6724
  • Fax: 740-592-6728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberNS-04232
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: