Provider Demographics
NPI:1518976331
Name:ROHADY, JO LYNN (MS RN CS)
Entity Type:Individual
Prefix:MS
First Name:JO
Middle Name:LYNN
Last Name:ROHADY
Suffix:
Gender:F
Credentials:MS RN CS
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Mailing Address - Street 1:1310 HIGHWAY 96 E
Mailing Address - Street 2:
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110-3624
Mailing Address - Country:US
Mailing Address - Phone:651-426-3071
Mailing Address - Fax:651-426-3095
Practice Address - Street 1:1310 HIGHWAY 96 E
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-3624
Practice Address - Country:US
Practice Address - Phone:651-426-3071
Practice Address - Fax:651-426-3095
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR055565560-0363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health