Provider Demographics
NPI:1164912523
Name:RODEHORST, MARIE DANIELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:DANIELLE
Last Name:RODEHORST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4214 38TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-1616
Mailing Address - Country:US
Mailing Address - Phone:402-564-1338
Mailing Address - Fax:402-606-4102
Practice Address - Street 1:4214 38TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-1616
Practice Address - Country:US
Practice Address - Phone:402-564-1338
Practice Address - Fax:402-606-4102
Is Sole Proprietor?:No
Enumeration Date:2018-05-11
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE33765207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine