Healthcare Provider Details

I. General information

NPI: 1508591249
Provider Name (Legal Business Name): AMANDA P ROHDE DNP, CRNP, AGPCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2022
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 KENILWORTH DR STE 203
TOWSON MD
21204-2354
US

IV. Provider business mailing address

5712 ROLAND AVE APT 1F
BALTIMORE MD
21210-1354
US

V. Phone/Fax

Practice location:
  • Phone: 410-296-5544
  • Fax: 410-296-5535
Mailing address:
  • Phone: 410-967-4114
  • Fax: 410-220-6300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberR201967
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: