Provider Demographics
NPI:1174577126
Name:ROHLICH, GLORIA ANNE (APN WHNP)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:ANNE
Last Name:ROHLICH
Suffix:
Gender:F
Credentials:APN WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WALLER ST
Mailing Address - Street 2:ATTN: FINANCE, 5TH FLOOR
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-5240
Mailing Address - Country:US
Mailing Address - Phone:512-978-9000
Mailing Address - Fax:512-978-9001
Practice Address - Street 1:1210 W. BRAKER LANE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-3308
Practice Address - Country:US
Practice Address - Phone:512-978-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX254713363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
P55555Medicare UPIN
TX8751N6Medicare PIN