Basic Information
| Provider Information | |||||||||
| NPI: | 1568837268 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROAN | ||||||||
| FirstName: | SEAN | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 411 OAK ST. | ||||||||
| Address2: | STERLING MEDICAL ASSOCIATES. ATTN: CREDENTIALS | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139841800 | ||||||||
| FaxNumber: | 5139844909 | ||||||||
| Practice Location | |||||||||
| Address1: | UNIT 5071 | ||||||||
| Address2: | |||||||||
| City: | APO | ||||||||
| State: | AP | ||||||||
| PostalCode: | 963285071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3152252714 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/07/2015 | ||||||||
| LastUpdateDate: | 10/17/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WG0000X | 041404504 | IL | N | Nursing Service Providers | Registered Nurse | General Practice | 363LF0000X | 209013559 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.