Basic Information
Provider Information
NPI: 1659776755
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROHLOFF
FirstName: COURTNEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: N.P.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 712 S CASCADE ST
Address2:  
City: FERGUS FALLS
State: MN
PostalCode: 565372913
CountryCode: US
TelephoneNumber: 2187368000
FaxNumber:  
Practice Location
Address1: 1411 HIGHWAY 79 E
Address2:  
City: ELBOW LAKE
State: MN
PostalCode: 565314647
CountryCode: US
TelephoneNumber: 2186857300
FaxNumber: 2186857296
Other Information
ProviderEnumerationDate: 10/31/2014
LastUpdateDate: 02/17/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X189085-3MNY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


Home