Beatty-Roloff, Mary M.

Beatty-Roloff, Mary M. is an sole proprietor health care provider with primary practice located at N2919 Cty Hwy Qq , Waupaca WI 54981. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Nursing Service Providers / Registered Nurse. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Beatty-Roloff, Mary M. can be contacted via phone (715) 258-2108.

Contact Information

Primary practice address
N2919 Cty Hwy Qq Waupaca WI 54981
Phone: (715) 258-2108
Fax: (715) 942-2199
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 3195 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 3195-033 Wisconsin
Nursing Service Providers / Registered Nurse 163W00000X 107505-030 Wisconsin

Profile Details

NPI number 1053505362
LBN Legal business name Beatty-Roloff, Mary M.
Credentials APNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 29th, 2007
Last updated Aug 26th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053505362 NPPES
Wisconsin Other 3195 WI STATE LICENSE

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