Provider Demographics
NPI:1891703120
Name:ROLLINSON, POON LANH (APRN)
Entity Type:Individual
Prefix:MS
First Name:POON
Middle Name:LANH
Last Name:ROLLINSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:POON
Other - Middle Name:BOPHAPHAL
Other - Last Name:LANH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:9909 BRIDGETON DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-1812
Mailing Address - Country:US
Mailing Address - Phone:850-321-9362
Mailing Address - Fax:
Practice Address - Street 1:6928 W LINEBAUGH AVE STE 102
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-5803
Practice Address - Country:US
Practice Address - Phone:813-749-7143
Practice Address - Fax:850-644-1578
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2856762363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner