Provider Demographics
NPI:1538826805
Name:ROSELLINI, NIKKI LOUISE
Entity type:Individual
Prefix:
First Name:NIKKI
Middle Name:LOUISE
Last Name:ROSELLINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 ARCHERS GLEN RD
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-6457
Mailing Address - Country:US
Mailing Address - Phone:814-207-3787
Mailing Address - Fax:
Practice Address - Street 1:428 STUDENT HEALTH CTR
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16802-2129
Practice Address - Country:US
Practice Address - Phone:814-863-0774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN264525164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse