Healthcare Provider Details

I. General information

NPI: 1861823338
Provider Name (Legal Business Name): SIDNEY ROHDE R.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: BRO. AUGUSTINE ROHDE R.N.

II. Dates (important events)

Enumeration Date: 12/09/2013
Last Update Date: 12/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 LAWRENCE ST
DENVER CO
80205-2126
US

IV. Provider business mailing address

2301 LAWRENCE ST
DENVER CO
80205-2126
US

V. Phone/Fax

Practice location:
  • Phone: 303-996-6061
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number0184545
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: