Provider Demographics
NPI:1437480514
Name:ROLLINS, JULIE (CRNP, FNP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:ROLLINS
Suffix:
Gender:F
Credentials:CRNP, FNP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:MACKLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP, FNP
Mailing Address - Street 1:17005 OLD ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-4828
Mailing Address - Country:US
Mailing Address - Phone:302-703-4025
Mailing Address - Fax:302-703-4027
Practice Address - Street 1:17005 OLD ORCHARD RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-4828
Practice Address - Country:US
Practice Address - Phone:302-703-4025
Practice Address - Fax:302-703-4027
Is Sole Proprietor?:No
Enumeration Date:2010-01-29
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC-001173363L00000X
DELG-0000674363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDAC-001173OtherSTATE OF MARYLAND
DELG-0000674OtherSTATE OF DELAWARE