MEDICARE: SHERELLE S ROLAND

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	164W00000X	Licensed Practical Nurse	167266	OH

General Provider Information

NPI Number	:	1831690643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERELLE S ROLAND

Provider Business Mailing Address
First Line	:	2709 ANDERSON FERRY RD APT 1
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-2138
Country	:	US
Telephone Number	:	513-344-9600
Fax Number	:

Provider Business Practice Location Address
First Line	:	2709 ANDERSON FERRY RD APT 1
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-2138
Country	:	US
Telephone Number	:	513-344-9600
Fax Number	:

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

Provider Enumeration Date	:	02/27/2018
Last Update Date	:	02/27/2018

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Directions to “ SHERELLE S ROLAND ” Practice Location

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