Provider Demographics
NPI:1356023576
Name:ROLAND, DESTINI (APRN-C)
Entity type:Individual
Prefix:
First Name:DESTINI
Middle Name:
Last Name:ROLAND
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:DESTINI
Other - Middle Name:
Other - Last Name:FARRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8907 KANIS RD STE 330
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6451
Mailing Address - Country:US
Mailing Address - Phone:501-224-8810
Mailing Address - Fax:
Practice Address - Street 1:8907 KANIS RD STE 330
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6451
Practice Address - Country:US
Practice Address - Phone:501-224-8810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR225693363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily