Provider Demographics
NPI:1528104684
Name:ROLLINS, SUE CHERIL (APRN, CCNS, RN)
Entity type:Individual
Prefix:
First Name:SUE
Middle Name:CHERIL
Last Name:ROLLINS
Suffix:
Gender:F
Credentials:APRN, CCNS, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12504 S DOBBS RD
Mailing Address - Street 2:
Mailing Address - City:MCLOUD
Mailing Address - State:OK
Mailing Address - Zip Code:74851-8458
Mailing Address - Country:US
Mailing Address - Phone:405-371-9829
Mailing Address - Fax:
Practice Address - Street 1:105 SE 45TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73129-3201
Practice Address - Country:US
Practice Address - Phone:405-634-4400
Practice Address - Fax:405-632-1976
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0058314363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health