Provider Demographics
NPI:1154128254
Name:ROLL, CALEIGH
Entity type:Individual
Prefix:MRS
First Name:CALEIGH
Middle Name:
Last Name:ROLL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 MUSIC LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-9409
Mailing Address - Country:US
Mailing Address - Phone:402-641-5172
Mailing Address - Fax:
Practice Address - Street 1:300 CAPITOL BEACH BLVD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68528-1643
Practice Address - Country:US
Practice Address - Phone:402-436-1159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE83540163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Single Specialty