Provider Demographics
NPI:1366872699
Name:ROLSTON, CANDACE LEAH (APRN/APN)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:LEAH
Last Name:ROLSTON
Suffix:
Gender:F
Credentials:APRN/APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 JACK STEPHENS DRIVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205
Mailing Address - Country:US
Mailing Address - Phone:501-686-6219
Mailing Address - Fax:501-526-5796
Practice Address - Street 1:629 JACK STEPHENS DRIVE
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-686-6219
Practice Address - Fax:501-526-5796
Is Sole Proprietor?:No
Enumeration Date:2013-11-22
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA003966363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology