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General NPI Number Information
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NPI Number | 1568837268
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Entity Type | Individual
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Provider Name | SEAN ROAN FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 12/07/2015
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Last Update Date | 10/17/2022
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Provider Practice Location Address
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Address Line | UNIT 5071
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City | APO
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State | AP
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Zip | 96328-5071
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Country | US
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Telephone | 315-225-2714
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Fax |
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Provider Business Mailing Address
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Address Line | 411 OAK ST. STERLING MEDICAL ASSOCIATES. ATTN: CREDENTIALS
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City | CINCINNATI
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State | OH
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Zip | 45219
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Country | US
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Telephone | 513-984-1800
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Fax | 513-984-4909
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 041404504
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209013559
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License Number State | IL
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