Provider Demographics
NPI:1255904603
Name:MCGHEE ROLLINS, LAWANDA LASHON
Entity type:Individual
Prefix:MRS
First Name:LAWANDA
Middle Name:LASHON
Last Name:MCGHEE ROLLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:FL
Mailing Address - Zip Code:32351-3665
Mailing Address - Country:US
Mailing Address - Phone:850-509-1449
Mailing Address - Fax:
Practice Address - Street 1:421 WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:FL
Practice Address - Zip Code:32351-3665
Practice Address - Country:US
Practice Address - Phone:850-509-1449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL237721251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health