Provider Demographics
NPI:1487234522
Name:ROLLINS, MARCUS (FNP-C)
Entity type:Individual
Prefix:
First Name:MARCUS
Middle Name:
Last Name:ROLLINS
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10240 W INDIAN SCHOOL RD STE 155
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-5909
Mailing Address - Country:US
Mailing Address - Phone:623-385-7900
Mailing Address - Fax:623-440-4360
Practice Address - Street 1:4338 W THOMAS RD STE 116
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031-3878
Practice Address - Country:US
Practice Address - Phone:623-385-7900
Practice Address - Fax:623-440-4360
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ256262363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily