Healthcare Provider Details

I. General information

NPI: 1063543387
Provider Name (Legal Business Name): LORRAINE KATHERINE ROHDE RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 W CHARLESTON BLVD
LAS VEGAS NV
89102-2329
US

IV. Provider business mailing address

2005 EMBREY AVE
LAS VEGAS NV
89106-3923
US

V. Phone/Fax

Practice location:
  • Phone: 702-383-2670
  • Fax:
Mailing address:
  • Phone: 702-386-2847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number511235
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number511235
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: