Provider Demographics
NPI:1295937076
Name:ROLLAR, DOROTHY M (LPN)
Entity type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:M
Last Name:ROLLAR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 ROSENHAYN AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-1240
Mailing Address - Country:US
Mailing Address - Phone:856-455-2577
Mailing Address - Fax:856-455-2577
Practice Address - Street 1:85 ROSENHAYN AVE
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-1240
Practice Address - Country:US
Practice Address - Phone:856-455-2577
Practice Address - Fax:856-455-2577
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP05220200164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse