Individual
KIMBERLY D ROLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1242 W SHIPLEY FERRY RD, KINGSPORT, TN 37663-3323
(423) 239-7300
(423) 239-7607
Mailing address
PO BOX 632476, CINCINNATI, OH 45263-2476
(423) 239-7300
(423) 239-7607
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101244717
VA
207Q00000X
Family Medicine Physician
Primary
50121
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1515804
—
TN
Enumeration date
08/20/2007
Last updated
02/21/2025
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