Provider Demographics
NPI:1427307370
Name:ROLLINS, JAMIE (RN)
Entity type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:
Last Name:ROLLINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3990 OLD TOWN AVE
Mailing Address - Street 2:SUITE107
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-2930
Mailing Address - Country:US
Mailing Address - Phone:619-688-1804
Mailing Address - Fax:619-688-1548
Practice Address - Street 1:3990 OLD TOWN AVE
Practice Address - Street 2:SUITE107
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-2930
Practice Address - Country:US
Practice Address - Phone:619-688-1804
Practice Address - Fax:619-688-1548
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA651646163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse