MEDICARE: MS. WENDI J ROLLINS CM

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	171M00000X	Case Manager/Care Coordinator	23738	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538440698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. WENDI J ROLLINS CM

Provider Business Mailing Address
First Line	:	8855 E RENO AVE STE 200
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110-7724
Country	:	US
Telephone Number	:	405-549-8606
Fax Number	:	405-300-0646

Provider Business Practice Location Address
First Line	:	8855 E RENO AVE STE 200
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110-7724
Country	:	US
Telephone Number	:	405-549-8606
Fax Number	:	405-300-0646

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

Provider Enumeration Date	:	09/02/2011
Last Update Date	:	02/21/2023

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