Provider Demographics
NPI:1154465383
Name:ROHAN, GENEVIEVE D (FNP)
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:D
Last Name:ROHAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 W SHAW AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3305
Mailing Address - Country:US
Mailing Address - Phone:559-226-5683
Mailing Address - Fax:559-226-1028
Practice Address - Street 1:2490 W SHAW AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3305
Practice Address - Country:US
Practice Address - Phone:559-226-5683
Practice Address - Fax:559-226-1028
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN365714163W00000X
CANP9873363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS65258GMedicare UPIN