Provider Demographics
NPI:1679551006
Name:ROHLOFF, HEIDI L (NP)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:L
Last Name:ROHLOFF
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 GREEN RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-1598
Mailing Address - Country:US
Mailing Address - Phone:734-686-6361
Mailing Address - Fax:734-661-0730
Practice Address - Street 1:23050 WEST RD
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN TWP
Practice Address - State:MI
Practice Address - Zip Code:48183-1472
Practice Address - Country:US
Practice Address - Phone:734-671-1370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704159649363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4489025Medicaid
MI4961219Medicaid
MI4624406Medicaid
MI500029473OtherRR MEDICARE
MI4843206Medicaid
MI4889043Medicaid
MI4489016Medicaid
MI4489052Medicaid
MI4489034Medicaid
MI4489025Medicaid
MIN511600020Medicare ID - Type Unspecified
MI4489034Medicaid
MI4489016Medicaid