Provider Demographics
NPI:1447790423
Name:ROHR, TABITHA SARAH (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:SARAH
Last Name:ROHR
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 N US HIGHWAY 63
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:MO
Mailing Address - Zip Code:63548-1076
Mailing Address - Country:US
Mailing Address - Phone:660-457-3655
Mailing Address - Fax:
Practice Address - Street 1:404 N US HIGHWAY 63
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:MO
Practice Address - Zip Code:63548-1076
Practice Address - Country:US
Practice Address - Phone:660-457-3655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-24
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOF06170013363LF0000X
MO2005025560163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse