Provider Demographics
NPI:1902254089
Name:ROHLEDER, TAMMY (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:ROHLEDER
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 SHERIDAN PL UNIT M
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-4642
Mailing Address - Country:US
Mailing Address - Phone:443-617-5805
Mailing Address - Fax:
Practice Address - Street 1:1303 SHERIDAN PL UNIT M
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-4642
Practice Address - Country:US
Practice Address - Phone:443-617-5805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-30
Last Update Date:2016-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR208209163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse