Healthcare Provider Details

I. General information

NPI: 1710236997
Provider Name (Legal Business Name): MRS. SHARON DIANE ROLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2012
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 44TH AVE
NORTHPORT AL
35476-7601
US

IV. Provider business mailing address

2450 44TH AVE
NORTHPORT AL
35476-7601
US

V. Phone/Fax

Practice location:
  • Phone: 205-478-3539
  • Fax:
Mailing address:
  • Phone: 205-478-3539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: