IndividualActive
Mary Koller, FNP-BC
NPI 1124055686 · Nurse Practitioner · Rome, GA
Provider details
- NPI number
- 1124055686
- Entity type
- Individual
- Primary specialty
- Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- FNP-BC
- Sex
- Female
- Sole proprietor
- No
- License
- RN218765 (GA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
504 Redmond Rd Nw
Rome, GA 30165-1416
Phone: (706) 235-3855
Fax: (706) 290-2721
Street-level locationGet directions
Mailing address
221 Technology Pkwy Nw
Rome, GA 30165-1369
Registry dates
- Enumerated
- 2006-06-28
- Last updated
- 2016-06-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.