Healthcare Provider Details
I. General information
NPI: 1295625762
Provider Name (Legal Business Name): ABIGAIL JANE ROLLINS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/07/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9500 EUCLID AVE
CLEVELAND OH
44195-0001
US
IV. Provider business mailing address
9500 EUCLID AVE
CLEVELAND OH
44195-0001
US
V. Phone/Fax
- Phone: 216-442-3681
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 50.009274RX |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 204D00000X |
| Taxonomy | Neuromusculoskeletal Medicine & OMM Physician |
| License Number | 50.009274RX |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: