JACQUELINE L ROETHLISBERGER NP NPI 1366561870

NPI Information

NPI: 1366561870
Provider Name: JACQUELINE L ROETHLISBERGER, NP
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

Organization: ALLIANCE PHYSICIANS INC

PECOS Registration: Yes

Address:
3533 SOUTHERN BOULEVARD
KETTERING, OH
ZIP 45429
Phone: (937) 395-8020
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Jacqueline L Roethlisberger, NP is an adult health nurse practitioner in Kettering, OH with 28 years of experience. Jacqueline L Roethlisberger, NP NPI is 1366561870. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3533 SOUTHERN BOULEVARD
KETTERING, OH
ZIP 45429
Phone: (937) 395-8020
Fax: (937) 395-8054

The NPI 1366561870 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/28/2007 and was last updated on 11/20/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	RN 199132 COA	OHIO	No
2	363LA2200X	Nurse Practitioner	Adult Health	COA 03334 NP	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	NP23483	MEDICARE PIN	OHIO
2	2731806	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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