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General NPI Number Information
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NPI Number | 1205677606
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Entity Type | Individual
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Provider Name | MICHAEL TODD ROHDE II DNP, FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 8300 CONSTITUTION AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-7613
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Country | US
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Telephone | 505-291-2122
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Fax |
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Provider Business Mailing Address
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Address Line | 213 COLORADO MOUNTAIN RD NE
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City | RIO RANCHO
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State | NM
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Zip | 87124-6319
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Country | US
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Telephone | 505-452-6410
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 80629
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 81246
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License Number State | NM
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