Provider Demographics
NPI:1306151337
Name:RODIEK, CAROL ANN (RRT)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:RODIEK
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12250 EAGLE RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NE
Mailing Address - Zip Code:68812
Mailing Address - Country:US
Mailing Address - Phone:308-440-6235
Mailing Address - Fax:
Practice Address - Street 1:12250 EAGLE RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NE
Practice Address - Zip Code:68812-2059
Practice Address - Country:US
Practice Address - Phone:308-440-6235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-14
Last Update Date:2010-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE21792279G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care