Healthcare Provider Details

I. General information

NPI: 1972030963
Provider Name (Legal Business Name): ANNE BETH ROLLINS MS RD CSSD LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 08/24/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 ADAMS ST
BURLINGTON MA
01803-4906
US

IV. Provider business mailing address

18 ADAMS ST
BURLINGTON MA
01803-4906
US

V. Phone/Fax

Practice location:
  • Phone: 781-999-2503
  • Fax:
Mailing address:
  • Phone: 781-999-2503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number963455
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: