Provider Demographics
NPI:1588322689
Name:ROHRICH-GREEN, DOLORES
Entity type:Individual
Prefix:
First Name:DOLORES
Middle Name:
Last Name:ROHRICH-GREEN
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 1:101 JUNIPER DR
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0291
Mailing Address - Country:US
Mailing Address - Phone:701-730-3351
Mailing Address - Fax:
Practice Address - Street 1:101 JUNIPER DR
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0291
Practice Address - Country:US
Practice Address - Phone:701-730-3351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant