Provider Demographics
NPI:1124036272
Name:ROLANDO, NADINE THERESE (CRNA)
Entity type:Individual
Prefix:MS
First Name:NADINE
Middle Name:THERESE
Last Name:ROLANDO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12037 CEDAR BLF
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-4108
Mailing Address - Country:US
Mailing Address - Phone:850-668-6806
Mailing Address - Fax:
Practice Address - Street 1:12037 CEDAR BLF
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-4108
Practice Address - Country:US
Practice Address - Phone:850-508-8602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2974812163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100162300Medicaid
OH0072078Medicaid
FL301635800Medicaid
IN201148790Medicaid
KY7100162300Medicaid
FL301635800Medicaid
OH0072078Medicaid