MEDICARE: MRS. LYNNE S ROLLINS RNC, APRN, FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN037833	GA

General Provider Information

NPI Number	:	1073511283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LYNNE S ROLLINS RNC, APRN, FNP

Provider Business Mailing Address
First Line	:	6345 REINHARDT COLLEGE PKWY
Second Line	:
City	:	WALESKA
State	:	GA
Zip	:	30183-3257
Country	:	US
Telephone Number	:	770-479-4613
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 BROAD ST
Second Line	:
City	:	ROME
State	:	GA
Zip	:	30161-3017
Country	:	US
Telephone Number	:	706-295-6701
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	07/08/2007

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