Healthcare Provider Details

I. General information

NPI: 1912868696
Provider Name (Legal Business Name): MORGAN ROHLOFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E BROADWAY
COLUMBIA MO
65215-1000
US

IV. Provider business mailing address

513 DEER CREEK RD
O FALLON IL
62269-6750
US

V. Phone/Fax

Practice location:
  • Phone: 573-442-2211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: