Provider Demographics
NPI:1104607951
Name:ROFKAHR, HANNAH ROSE (MS, RDN, LD)
Entity type:Individual
Prefix:MISS
First Name:HANNAH
Middle Name:ROSE
Last Name:ROFKAHR
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3115 LONGVIEW RD
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AR
Mailing Address - Zip Code:72949-8139
Mailing Address - Country:US
Mailing Address - Phone:479-209-9303
Mailing Address - Fax:
Practice Address - Street 1:3115 LONGVIEW RD
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AR
Practice Address - Zip Code:72949-8139
Practice Address - Country:US
Practice Address - Phone:479-209-1903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR86299731133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered