Provider Demographics
NPI:1649885401
Name:ROTTINGHAUS, MARCIA R
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:R
Last Name:ROTTINGHAUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 UTAH ST
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:KS
Mailing Address - Zip Code:66434-2314
Mailing Address - Country:US
Mailing Address - Phone:785-742-6229
Mailing Address - Fax:785-742-6558
Practice Address - Street 1:300 UTAH ST
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:KS
Practice Address - Zip Code:66434-2314
Practice Address - Country:US
Practice Address - Phone:785-742-6229
Practice Address - Fax:785-742-6558
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1366566163WC3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC3500XNursing Service ProvidersRegistered NurseCardiac Rehabilitation