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General NPI Number Information
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NPI Number | 1881875458
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Entity Type | Organization
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Legal Business Name | FAMILY NURSE PRCTITIONER HEALTH ASSOC,PC
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Dates
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Enumeration Date | 11/23/2007
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Last Update Date | 11/23/2007
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Provider Practice Location Address
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Address Line | 10 PRINCE STREET SUITE 7
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City | MONTICELLO
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State | NY
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Zip | 12701
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Country | US
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Telephone | 845-794-7943
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Fax |
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Provider Business Mailing Address
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Address Line | 10 PRICE STREET SUITE 7
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City | MONTICELLO
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State | NY
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Zip | 12701
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Country | US
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Telephone | 845-794-7943
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL ROLLINS
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Credential | FNP
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Telephone | 845-707-1245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 331600
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License Number State | NY
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