Provider Demographics
NPI:1508245838
Name:ATKINS, ROD LANCE (ARNP)
Entity Type:Individual
Prefix:
First Name:ROD
Middle Name:LANCE
Last Name:ATKINS
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 SPRING FOREST RD # 2313
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-7528
Mailing Address - Country:US
Mailing Address - Phone:919-790-6401
Mailing Address - Fax:
Practice Address - Street 1:2340 SPRING FOREST RD # 2313
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-7528
Practice Address - Country:US
Practice Address - Phone:919-790-6401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-19
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3247082363LF0000X
FLARNP3247082363LF0000X
NC505017588363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5017588OtherSTATE LICENSE