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General NPI Number Information
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NPI Number | 1730709544
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Entity Type | Individual
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Provider Name | JUSTIN C ROLAND CRNP, AGACNP-BC
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Gender | Male
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Dates
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Enumeration Date | 04/22/2020
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | 1802 6TH AVE S
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City | BIRMINGHAM
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State | AL
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Zip | 35233-1932
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Country | US
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Telephone | 205-394-2440
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Fax |
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Provider Business Mailing Address
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Address Line | 3400 BIG PAUL CIR
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City | VESTAVIA HILLS
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State | AL
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Zip | 35216-4814
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Country | US
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Telephone | 256-861-0314
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1-154461
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1-154461
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License Number State | AL
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