MEDICARE: MAI-LIN ROLLON CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	217854	AZ

General Provider Information

NPI Number	:	1972088524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAI-LIN ROLLON CNM

Provider Business Mailing Address
First Line	:	3815 S VAL VISTA DR STE 101
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85297-7309
Country	:	US
Telephone Number	:	480-782-0993
Fax Number	:	855-329-8939

Provider Business Practice Location Address
First Line	:	22711 S ELLSWORTH RD STE 104
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142-6789
Country	:	US
Telephone Number	:	480-782-0993
Fax Number	:	833-337-0386

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2018
Last Update Date	:	06/08/2026

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