Healthcare Provider Details

I. General information

NPI: 1265326946
Provider Name (Legal Business Name): COLE ERIC ROKKE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 07/05/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12631 E 17TH AVE
AURORA CO
80045-2527
US

IV. Provider business mailing address

5225 23RD AVE S
FARGO ND
58104-7927
US

V. Phone/Fax

Practice location:
  • Phone: 303-724-1981
  • Fax:
Mailing address:
  • Phone: 701-234-5933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTL.0011187
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: