Basic Information
Provider Information
NPI: 1356464333
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROFKAHR
FirstName: JENIFER
MiddleName: LYN
NamePrefix: MRS.
NameSuffix:  
Credential: ACNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SCHNARR
OtherFirstName: JENIFER
OtherMiddleName: LYN
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: ACNP
OtherLastNameType: 1
Mailing Information
Address1: 1300 ETHAN WAY STE 600
Address2:  
City: SACRAMENTO
State: CA
PostalCode: 958252296
CountryCode: US
TelephoneNumber: 9166793590
FaxNumber: 9164823647
Practice Location
Address1: 1485 RIVER PARK DR STE 200
Address2:  
City: SACRAMENTO
State: CA
PostalCode: 958154530
CountryCode: US
TelephoneNumber: 9163251040
FaxNumber: 9166694100
Other Information
ProviderEnumerationDate: 04/06/2007
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100XNPF15912CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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