Provider Demographics
NPI:1962238568
Name:ROESLER, DARLLA ANN (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:DARLLA
Middle Name:ANN
Last Name:ROESLER
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:MS
Other - First Name:DARLLA
Other - Middle Name:ANN
Other - Last Name:KAUFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:530 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-6329
Mailing Address - Country:US
Mailing Address - Phone:707-784-7154
Mailing Address - Fax:
Practice Address - Street 1:530 UNION AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-6329
Practice Address - Country:US
Practice Address - Phone:707-784-7154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA356002163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse