Healthcare Provider Details

I. General information

NPI: 1417441882
Provider Name (Legal Business Name): KIRSTEN GRACE ROHDE NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2018
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4214 38TH ST
COLUMBUS NE
68601-1616
US

IV. Provider business mailing address

PO BOX 232
SILVER CREEK NE
68663-0232
US

V. Phone/Fax

Practice location:
  • Phone: 402-564-1338
  • Fax: 402-564-8902
Mailing address:
  • Phone: 402-276-1252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number112482
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: