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General NPI Number Information
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NPI Number | 1508311150
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Entity Type | Individual
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Provider Name | DAWN MARIE ROELOFS NP-C, CRNP
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Gender | Female
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Dates
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Enumeration Date | 08/23/2016
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Last Update Date | 10/13/2016
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Provider Practice Location Address
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Address Line | 7962 COVINGTON AVE
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City | GLEN BURNIE
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State | MD
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Zip | 21061-4875
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Country | US
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Telephone | 410-245-1806
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Fax |
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Provider Business Mailing Address
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Address Line | 7962 COVINGTON AVE
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City | GLEN BURNIE
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State | MD
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Zip | 21061-4875
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Country | US
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Telephone | 410-245-1806
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R143946
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN669051
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN1038448
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License Number State | DC
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R143946
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License Number State | MD
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