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General NPI Number Information
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NPI Number | 1790777084
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Entity Type | Individual
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Provider Name | RACHEL C ROLLER CRNA
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Gender | Female
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 601 MED TECH PKWY
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City | JOHNSON CITY
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State | TN
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Zip | 37604-2253
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Country | US
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Telephone | 423-610-1020
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Fax |
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Provider Business Mailing Address
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Address Line | 1009 LARK ST STE 2
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City | JOHNSON CITY
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State | TN
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Zip | 37604-8218
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Country | US
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Telephone | 423-283-0776
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Fax | 423-968-5697
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN0000122629
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 0024193694
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License Number State | VA
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