Healthcare Provider Details

I. General information

NPI: 1336945252
Provider Name (Legal Business Name): ADRIANA ROLLYSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2025
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 COLLIERS WAY
WEIRTON WV
26062-5014
US

IV. Provider business mailing address

601 COLLIERS WAY
WEIRTON WV
26062-5014
US

V. Phone/Fax

Practice location:
  • Phone: 304-797-6495
  • Fax: 304-797-6496
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number117847
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: