Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | R143674 | MD |
N | 363LA2200X | Nurse Practitioner - Adult Health | R143674 | MD |
N | 363LG0600X | Nurse Practitioner - Gerontology | R143674 | MD |
NPI | 1003384165 |
---|---|
Provider Name | Dr. Lawanda Rollins |
First Address | Parkville, MD 21234-6130 |
Second Address | Timonium, MD 21093-2739 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2018 |
Last Update Date | 08/02/2019 |