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Individual
JENNA ELIZABETH ROLLER
Active
Individual
JENNA ELIZABETH ROLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2950
SC
363AS0400X
Surgical Physician Assistant
Primary
C0004965
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11011359
NCCPA
—
01
—
2950
SC PA LICENSE
SC
01
—
C0004965
MARYLAND BOARD OF PHYSICIANS
—
Enumeration date
02/04/2013
Last updated
03/31/2018
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