Healthcare Provider Details

I. General information

NPI: 1760011449
Provider Name (Legal Business Name): HOWARD EDWARD ROLLINS III FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2020
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 MALCOLM DR STE A
WESTMINSTER MD
21157-6160
US

IV. Provider business mailing address

10200 GRAND CENTRAL AVE STE 220
OWINGS MILLS MD
21117-4366
US

V. Phone/Fax

Practice location:
  • Phone: 410-876-1633
  • Fax:
Mailing address:
  • Phone: 410-581-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR218136
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: