Individual
BRANDON ROLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
900 E BROADWAY AVE, BISMARCK, ND 58501-4520
(701) 530-7000
Mailing address
PO BOX 997, BISMARCK, ND 58502-0997
(701) 530-7000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R32484
ND
367500000X
Certified Registered Nurse Anesthetist
Primary
R32484
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1453501
—
ND
Enumeration date
01/30/2014
Last updated
07/08/2016
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