Provider Demographics
NPI:1659641116
Name:NEELEY-ROLLINS, REBECCA (CNP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:NEELEY-ROLLINS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 BERKSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-1525
Mailing Address - Country:US
Mailing Address - Phone:440-320-8325
Mailing Address - Fax:855-544-5014
Practice Address - Street 1:229 BERKSHIRE RD
Practice Address - Street 2:
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-1525
Practice Address - Country:US
Practice Address - Phone:440-933-3237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-30
Last Update Date:2017-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA12530NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health