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General NPI Number Information
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NPI Number | 1891054011
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Entity Type | Individual
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Provider Name | ROXANNE KASSELMANN R.N.
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Gender | Female
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Dates
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Enumeration Date | 05/08/2012
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Last Update Date | 05/08/2012
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Provider Practice Location Address
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Address Line | 1501 CAPITOL AVE # MS 4502
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City | SACRAMENTO
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State | CA
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Zip | 95814-5005
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Country | US
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Telephone | 916-558-1805
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Fax |
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Provider Business Mailing Address
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Address Line | 3300 PARKSIDE DR APT 2
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City | ROCKLIN
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State | CA
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Zip | 95677-2540
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Country | US
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Telephone | 406-461-2207
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 573562
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License Number State | CA
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