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NPI Code Detail

MEDICARE: MRS. CAROLYN ROETERING CRNP

MEDICARE: MRS. CAROLYN ROETERING CRNP
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
1363LF0000XFamily Nurse PractitionerR178240MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1919617-01OTHERMDBC/BS
2S062-0321OTHERMDBC/BS REGIONAL

General Provider Information

NPI Number : 1265501001
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAROLYN ROETERING CRNP
Provider Business Mailing Address
First Line : 5964 GOLF CLUB LN
Second Line :
City : HAMILTON
State : OH
Zip : 45011-8224
Country : US
Telephone Number : 513-893-1100
Fax Number : 513-893-1128
Provider Business Practice Location Address
First Line : 5964 GOLF CLUB LN
Second Line :
City : HAMILTON
State : OH
Zip : 45011-8224
Country : US
Telephone Number : 513-893-1100
Fax Number : 513-893-1128
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 01/30/2014

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Directions to “ MRS. CAROLYN ROETERING CRNP” Practice Location

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