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NPI Code Detail

MEDICARE: SUE CHERIL ROLLINS APRN, CCNS, RN

MEDICARE: SUE CHERIL ROLLINS APRN, CCNS, RN
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerR0058314OK

General Provider Information

NPI Number : 1528104684
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUE CHERIL ROLLINS APRN, CCNS, RN
Provider Business Mailing Address
First Line : 12504 S DOBBS RD
Second Line :
City : MCLOUD
State : OK
Zip : 74851-8458
Country : US
Telephone Number : 405-371-9829
Fax Number :
Provider Business Practice Location Address
First Line : 105 SE 45TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73129-3201
Country : US
Telephone Number : 405-634-4400
Fax Number : 405-632-1976
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2007
Last Update Date : 12/31/2009

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