Provider Demographics
NPI:1023265899
Name:ROHAN, MARIE (RN, MS)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:
Last Name:ROHAN
Suffix:
Gender:F
Credentials:RN, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 S SYCAMORE KNLS
Mailing Address - Street 2:
Mailing Address - City:SOUTH HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01075-1112
Mailing Address - Country:US
Mailing Address - Phone:413-582-3045
Mailing Address - Fax:
Practice Address - Street 1:421 NORTH MAIN STREET
Practice Address - Street 2:VAMC
Practice Address - City:LEEDS
Practice Address - State:MA
Practice Address - Zip Code:01052
Practice Address - Country:US
Practice Address - Phone:413-582-2628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA84549163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator