Provider Demographics
NPI:1821310095
Name:ROLLING, KELLEN MILLER (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:KELLEN
Middle Name:MILLER
Last Name:ROLLING
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 KENTUCKY AVE STE 113
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1813
Mailing Address - Country:US
Mailing Address - Phone:205-971-1515
Mailing Address - Fax:
Practice Address - Street 1:1919 KENTUCKY AVE STE 113
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-1813
Practice Address - Country:US
Practice Address - Phone:205-971-1515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-15
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-111884363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily