Healthcare Provider Details

I. General information

NPI: 1124953971
Provider Name (Legal Business Name): WHITNEY ROHDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 N 2100 W
SALT LAKE CITY UT
84116-2991
US

IV. Provider business mailing address

130 N 2100 W
SALT LAKE CITY UT
84116-2991
US

V. Phone/Fax

Practice location:
  • Phone: 385-430-2112
  • Fax: 385-430-2112
Mailing address:
  • Phone: 385-430-2112
  • Fax: 385-430-2112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: