Healthcare Provider Details

I. General information

NPI: 1588238331
Provider Name (Legal Business Name): JOHN GABRIEL ROLSHOVEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JOHN GABRIEL KUNCHEFF ROLSHOVEN

II. Dates (important events)

Enumeration Date: 05/17/2021
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2385 E PRATER WAY STE 205
SPARKS NV
89434-9688
US

IV. Provider business mailing address

2385 E PRATER WAY STE 205
SPARKS NV
89434-9688
US

V. Phone/Fax

Practice location:
  • Phone: 775-356-4888
  • Fax:
Mailing address:
  • Phone: 775-356-4888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number27781
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207PS0010X
TaxonomySports Medicine (Emergency Medicine) Physician
License Number27781
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: