Provider Demographics
NPI:1891226759
Name:ROHAN, MICHAEL (FNP)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:ROHAN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 HEMLOCK FARMS
Mailing Address - Street 2:
Mailing Address - City:LORDS VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18428-9064
Mailing Address - Country:US
Mailing Address - Phone:570-775-9394
Mailing Address - Fax:
Practice Address - Street 1:1300 HEMLOCK FARMS
Practice Address - Street 2:
Practice Address - City:LORDS VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18428-9064
Practice Address - Country:US
Practice Address - Phone:570-775-9394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY341653363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily