Ms Kelly A Roetman, APN | |
973 Mica Dr Ste 201, Carson City, NV 89705 | |
(775) 783-6190 | |
(775) 783-6191 |
Full Name | Ms Kelly A Roetman |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Location | 973 Mica Dr Ste 201, Carson City, Nevada |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1821089376 | NPI | - | NPPES |
CC9627 | Other | NV | BCBS |
1821089376 | Medicaid | NV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 513594 (California) | Secondary |
163W00000X | Registered Nurse | 26083 (Nevada) | Secondary |
363L00000X | Nurse Practitioner | APN000605 (Nevada) | Primary |
Entity Name | Tahoe Fracture And Orthopedic Medical Clinic, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1750372140 PECOS PAC ID: 8628979267 Enrollment ID: O20040116000723 |
Mailing Address | Practice Location Address |
---|---|
Ms Kelly A Roetman, APN 973 Mica Dr Ste 201, Carson City, NV 89705-7258 Ph: (775) 783-6190 | Ms Kelly A Roetman, APN 973 Mica Dr Ste 201, Carson City, NV 89705 Ph: (775) 783-6190 |
Brittney Ann Fencl, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1201 S Carson St, Carson City, NV 89701 Phone: 775-445-7220 Fax: 775-841-1139 | |
David L. Ramsey, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 205 S Pratt Ave, Carson City, NV 89701 Phone: 775-882-3945 Fax: 775-882-6126 | |
Bonnie J O'daye, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1385 Vista Ln, Carson City, NV 89703 Phone: 775-884-4567 | |
Ms. Jean Cozad Lyon, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1910 College Pkwy, Suite 130, Carson City, NV 89706 Phone: 775-885-6940 | |
Emanuella Pomerlyan, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1200 Mountain St, Carson City, NV 89703 Phone: 775-882-1324 | |
Mrs. Carla Rae Farnworth, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 300 Cambridge Ct, Carson City, NV 89701 Phone: 775-885-1520 | |
Tiffany L. Yohey, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 727 Fairview Dr Ste A, Carson City, NV 89701 Phone: 775-684-5010 Fax: 775-687-1181 |