Provider Demographics
NPI:1548735434
Name:ROHLER, JENNIFER LYNDA (MSN FNP-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNDA
Last Name:ROHLER
Suffix:
Gender:F
Credentials:MSN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3545 CHEYENNE AVE
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86401-6507
Mailing Address - Country:US
Mailing Address - Phone:928-279-5553
Mailing Address - Fax:
Practice Address - Street 1:2668 HUALAPAI MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401-8387
Practice Address - Country:US
Practice Address - Phone:928-718-7300
Practice Address - Fax:928-753-4998
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-08
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11787363LP2300X
AZAP11781363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care