Provider Demographics
NPI:1427568328
Name:ROLLINS MARTIN, PATRICIA KAYE (BSN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:KAYE
Last Name:ROLLINS MARTIN
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21142 LILAC MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-7024
Mailing Address - Country:US
Mailing Address - Phone:832-588-8732
Mailing Address - Fax:
Practice Address - Street 1:21142 LILAC MEADOWS LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-7024
Practice Address - Country:US
Practice Address - Phone:832-588-8732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-05
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRCP000671462279P1005X, 2279S1500X
TX921708163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitationGroup - Single Specialty
No2279P1005XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary RehabilitationGroup - Single Specialty
No2279S1500XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredSNF/Subacute Care