Provider Demographics
NPI:1164097457
Name:ROHRER, ADRIANE RENE (AGACNP)
Entity Type:Individual
Prefix:
First Name:ADRIANE
Middle Name:RENE
Last Name:ROHRER
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:ADRIANE
Other - Middle Name:RENE
Other - Last Name:ZAJDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGACNP
Mailing Address - Street 1:2745 E SOUTHWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-8770
Mailing Address - Country:US
Mailing Address - Phone:480-754-9973
Mailing Address - Fax:
Practice Address - Street 1:2745 E SOUTHWOOD RD
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-8770
Practice Address - Country:US
Practice Address - Phone:480-754-9973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-20
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2021000872363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care