Healthcare Provider Details

I. General information

NPI: 1558751206
Provider Name (Legal Business Name): NATOSHA MANNING-ROLLINS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2015
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 OLD JEFFERSON RD BLDG 800
ATHENS GA
30607-1400
US

IV. Provider business mailing address

3320 OLD JEFFERSON RD BLDG 800
ATHENS GA
30607-1400
US

V. Phone/Fax

Practice location:
  • Phone: 706-353-2990
  • Fax: 706-353-2992
Mailing address:
  • Phone: 706-353-2990
  • Fax: 706-353-2992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-NP194599
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN-NP194599
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9394344
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: