MEDICARE: MRS. CALEIGH ROLL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WS0200X	School Registered Nurse	83540	NE

General Provider Information

NPI Number	:	1154128254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CALEIGH ROLL

Provider Business Mailing Address
First Line	:	5100 MUSIC LN
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68516-9409
Country	:	US
Telephone Number	:	402-641-5172
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 CAPITOL BEACH BLVD
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68528-1643
Country	:	US
Telephone Number	:	402-436-1159
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2025
Last Update Date	:	02/26/2025

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Directions to “ MRS. CALEIGH ROLL ” Practice Location

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