Provider Demographics
NPI:1053690719
Name:ROLLER, KARRIE BETH
Entity type:Individual
Prefix:
First Name:KARRIE
Middle Name:BETH
Last Name:ROLLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2708 ALT 19TH NORTH
Mailing Address - Street 2:SUITE 501
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683
Mailing Address - Country:US
Mailing Address - Phone:727-785-2762
Mailing Address - Fax:
Practice Address - Street 1:2708 ALT 19TH NORTH
Practice Address - Street 2:SUITE 501
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683
Practice Address - Country:US
Practice Address - Phone:727-785-2762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator