Provider Demographics
NPI:1508591249
Name:ROHDE, AMANDA P (DNP, CRNP, AGPCNP)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:P
Last Name:ROHDE
Suffix:
Gender:F
Credentials:DNP, CRNP, AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5712 ROLAND AVE APT 1F
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1354
Mailing Address - Country:US
Mailing Address - Phone:410-967-4114
Mailing Address - Fax:
Practice Address - Street 1:5712 ROLAND AVE APT 1F
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-1354
Practice Address - Country:US
Practice Address - Phone:410-967-4114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR201967363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care