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Individual
MS. KELLY A ROETMAN
Active
Individual
MS. KELLY A ROETMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26083
NV
163W00000X
Registered Nurse
513594
CA
363L00000X
Nurse Practitioner
Primary
APN000605
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821089376
—
NV
01
—
CC9627
BCBS
NV
Enumeration date
11/03/2005
Last updated
05/25/2018
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