Provider Demographics
NPI:1265149728
Name:ROHN, JONATHAN PATRICK
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:PATRICK
Last Name:ROHN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 N GREENFIELD RD APT 156
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-7837
Mailing Address - Country:US
Mailing Address - Phone:623-232-1440
Mailing Address - Fax:
Practice Address - Street 1:220 N GREENFIELD RD APT 156
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-7837
Practice Address - Country:US
Practice Address - Phone:623-329-4780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty